To help make your first visit to our practice as smooth as possible, please read the information on this web page. You'll find all the practical information you need, such as a map and directions to our office(s), practice hours, payment policies and more. We also describe our first visit procedures. And, you can save some time by printing out and completing the new patient forms in advance of your appointment.
Please arrive 15 minutes early for your appointment to allow time to complete new patient forms and registration. We also invite you to review Our Office Policies regarding appointments, insurance, and billing information prior to your appointment.
Please bring the following items and information with you to your appointment:
- Insurance Cards
- Drivers License or government-issued photo ID
- Medical Records and Reports
- Hearing Test Results
- Imaging Disc (MRI, CT Scan, X-ray)
- Paper Referral, if required by your insurance company
- Completed Registration Packet
- Registration Packet
- Consent for In-Office Procedures
- Release of Medical Records Form
- Photograph and/or Video Release
- Consent for Email Communications
- Patient Satisfaction Survey and Testimonial
Advance Beneficiary Notices (for procedures and services not covered by insurance)
- Blue Cross Blue Shield & United Healthcare ABN for AERA eustachian tube dilations
- Anthem Blue Cross ABN for sinus debridement
- Medicare ABN for RAST blood testing for allergies
- ABN for Sublingual Immunotherapy for Commercial Insurance
- ABN for Sublingual Immunotherapy for Medicare
***If you would like to fill out these forms online and email them to our office you will need to fill out the form you need AND the Consent for Email Communications form! Save the completed forms to your own computer and attach both forms to your Email. Send all forms to: email@example.com or fax them to 402-778-5216.
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.