Please complete the Patient Registration Form before coming in for your appointment. If any patient information has changed since your last visit, for example, your insurance carrier or your address, please complete another Patient Registration Form as well.
If you are a new patient or if you have not been to our office in 2 years, please fill out the New Patient and Long Term Follow-up Patient Information form in addition to the Patient Registration form.
If you are having a minor child brought to the office, and the parent or legal gaurdian will not be present, please fill out the Authorization for Consent to Medical Treatment for a Minor.
Authorization for Consent to Medical Treatment for a Minor
If your minor child is unaccompanied, please fill out the form below.
Authorization for Consent to Medical Treatment for Unaccompanied Minor
Carolina Ear Nose & Throat Head and Neck Surgery Center