Patient Registration Forms

The following forms are required on file in your chart. For your convenience, these forms are available for download. When possible, we encourage you to download these forms, print them, and carefully read and complete them prior to your initial office visit. Bring the completed forms with you on your visit and present them to the reception desk. In this way, we can provide you with better service.

Patient Information Form (48 KB Adobe PDF)

Patient Questionnaire (110 KB Adobe PDF)

Fees and Billing Policy (44 KB Adobe PDF)

Do I Have Sleep Apnea? (36 KB Adobe PDF)

Preoperative Forms

This form contains standard instructions for patients scheduled to undergo surgery. Please note that your physician may offer different or additional instructions during your preoperative visit. Always follow your physician’s instructions explicitly. If you are unsure of any point, please do not hesitate to contact your physician.

Instructions for Patients Undergoing Surgery (64 KB Adobe PDF)

Postoperative Forms

These forms contain standard postoperative instructions for patients undergoing surgery. Select the appropriate form depending upon the surgical procedure performed. Please note that your physician may offer different or additional instructions during your preoperative or postoperative visit. Always follow your physician’s instructions explicitly. If you are unsure of any point, please do not hesitate to contact your physician.

Adenoidectomy (60 KB Adobe PDF)

Information on Laryngoscopy, Bronchoscopy, Esophagoscopy

(53 KB Adobe PDF)

Information on Myringotomy and Tube Insertion

(104 KB Adobe PDF)

Surgery Information on Nasal Airway Reconstruction and/or Endoscopic Sinus Surgery (108 KB Adobe PDF)

Surgery Information on Tongue Base Reduction Procedures

(52 KB Adobe PDF)

Surgery Information for Uvulopalatopharygoplasty and/or Tongue Base Reduction Procedures (52 KB Adobe PDF)

Thyroidectomy (128 KB Adobe PDF)