- Patient Registration Form
- Minor Patient Registration Form
- Medical Record Release Form
- Notice of Privacy Practices
- Terms of Use
- Non-Discrimination Statement
- Non-Discrimination Statement Multi-Language
- Your Right to an Interpreter Form
- Health History Form
- Right to Receive a Good Faith Estimate of Expected Charges Notice
- Delegate Authorized to Accompany a Minor Form
- Request Medical Records with ChartFast
Insurance Claims and Payment
Payment is due at time of service. For payment details visit our Financial Policy. This includes all copayments, coinsurances and deductibles. Your insurance card must be presented for verification at each visit.
We accept cash, check, Visa, MasterCard, American Express and Discover.
Ear, Nose and Throat Specialists are in-network providers for many plans. Please check with your insurance company for verification of benefits.