Patient Forms


Please Print and Complete the Following Forms

  1. Adult Questionnaire OR Pediatric/Adolescent Questionnaire
  2. HIPAA/Patient Acknowledgment of Privacy Practices
  3. If your visit is related to dizziness, balance, or vertigo, please print this form.
  4. If your visit is related to snoring concerns, please print this form.

Please Review the Following Form (No Need to Print)


Please Arrive 10-15 Minutes Early and Bring the Following

  1. Your insurance card(s)
  2. A photo id
  3. Referral (if required by your insurance carrier)
  4. Co-pay (if required by your insurance carrier)

We accept cash, check, and all major credit cards.


For established patients returning for special testing


If you have been seen at an outside facility which has records pertinent to your condition