Ear, Nose & Throat: Forms
Please complete and print the forms below, and bring with you on your visit.
Adult Intake Form
Child Intake Form
The Release of Information Form (in the Adult/Child Intake Forms) must be completed in its entirety before any medical records can be released. The patient's signature and a copy of their photo ID is also required, along with a witness signature. (It can be anybody over the age of 18).