Forms and Questionnaires

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New Patient Registration Forms

• Patient Profile
• Summary of Privacy Practices
• Financial Policy
• Patient's Authorization Form regarding:
  • Release of Information
  • Assignment of Insurance Benefits
  • Receipt of Privacy Practices
• Patient History

Clinical Questionnaires

• Dizziness Questionnaire
• Sleep Disorders Questionnaire
• Allergy History Questionnaire
• Voice Related Quality of Life Measure
• Vocal Hygiene

Other Information

Review of this information and common questions & answers should never replace a complete examination and consultation by a physician.

• Post Operative Instructions
• Nosebleed Instructions
• Reflux Diet
• Salt Water Rinse for the Nose
• Sleep Apnea
• Videonystagmography (VNG/ENG) Instructions
• Allergy Testing Instructions
• Public Programs for Speech & Language

Reference Links

The following sites offer useful information on all aspects of otolaryngology.

• American Academy of Otolaryngology - Head and Neck Surgery
• The EAR Foundation
• The Ear, Nose and Throat Page for Parents
• Support for People with Oral and Head and Neck Cancer