Are you a new patient? If so, these may be useful to you.
You can now fill out your paperwork at home for your convenience! Complete online via the secure Patient Portal or download and print. Arriving with completed patient forms prior to your visit will help to ensure timely check-in at the time of your appointment.
- If you have not completed your paperwork prior to your scheduled appointment, please arrive 30 minutes early to ensure that you have adequate time to complete our new patient intake process.
- 24 hour cancellation notice is required. Failure to do so will result in a fee.
- Failure to keep your appointment without a cancellation, will result in a “no show” charge.
We will also require the following information for your fist visit:
- Driver’s License or Other Valid Government-Issued Photo Identification
- Insurance card and any co-payment due for visit
- Referral or consultation form if applicable
- Prior X-Rays, MRI Films, CT Scans, or EMG (please bring the films or CD-ROM containing the images with the paper report)
- List of current medications (this is very important)
- Any pertinent medical history such as lab results
- Know your surgical history
Please note: by law, minors must be accompanied by a parent or guardian or provide written consent from a parent or guardian.
Enticare Ear, Nose and Throat is now offering a secure Patient Portal for the convenience of our patients. Just click on the link to access your personal portal. After logging on, you will be instructed on how to complete the Patient Paperwork.
**Download and print. Bring the completed forms to your first visit so you do not have to arrive early.
New Patient Paperwork
Patient Paperwork (Español)
Medication History Consent
Medical Release Form
Adult Sleep Study Questionaire
Pediatric Sleep Study
Epworth Sleepiness Scale – adult
Epworth Sleepiness Scale – peds