Completing these forms PRIOR to your visit will shorten your registration time.
**Please fill out form 1 OR 2 (depending on your type of visit) as well as forms 3-7 below, and bring those to your first visit…
- 1-EHR NP Questionnaire
- 2- New Patient Questionnaire – ENT
- 3- New Patient Consent Forms
- 4- New Patient registration
- 5- Privacy Notice
- 6- Health Care Team
- 7- Assignment of Benefits & Release Information
- 8- Contact Consent
Print and complete the Established Patient Form no more than 24 hrs before your visit to shorten wait time.
- 1- Established Patient Questionnaire- ALLERGY
- 2- Established Patient Questionnaire- ENT
- 3- Established Patient Demographics
- 4- Medical Records Release
- 1- Authorization to Prepare Allergen Extract
- 2- Allergy & Asthma immunotherapy Re-Evaluation
- 3- Immunotherapy Treatment Acknowledgement Letter
- 4- Allergy Extract Release Form
If you or your family feel you are having difficulty communicating due to hearing loss, take our Hearing Loss Questionnaire.