New Patient Consultation
If you are a new patient, and would like to schedule an appointment, please complete the form below.
Forms
If you are a new patient to our clinic, you may save time by completing the following forms prior to arriving for your appointment.
New Patient Packet
Please click here to download our New Patient forms.
-Medical Questionnaire
-Patient Demographics
-Insurance Verification
-Privacy Policy and Receipt
Additional Forms For Allergy Patient
Diet History
Allergy Re-evaluation Questionnaire
Patient Instructions Acute Rhinosinusitis
Additional Forms
Release of Medical Information
Gastroesophageal Reflux (GER)
Dizziness Questionnaire
The Reduced Sodium Diet
Vestibular Exercises
Ears and Nose
Care of Ears During Airplane Flight
Reflux Symptom Index
Epworth Sleepiness Scale
Placement of Pressure Equalization Tubes
To view and print a form, please click on the appropriate Link. The forms require that you have Adobe Acrobat Reader installed.
Did You Know?
Ringing in the ears may be a “tip-off” to a change in your hearing. It is experienced by as many as 60 million Americans who complain of worsening during quiet periods.
