{"id":154,"date":"2019-08-14T12:17:25","date_gmt":"2019-08-14T16:17:25","guid":{"rendered":"https:\/\/easternshoreent.fm1.dev\/resources\/patient-forms\/"},"modified":"2024-03-27T14:42:12","modified_gmt":"2024-03-27T18:42:12","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/easternshoreent.com\/resources\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\n

Pre\/Post Operative Information<\/strong><\/h4>\n\n\n\n
Post-Op Instructions for Nasal Surgery<\/a>Download<\/a><\/div>\n\n\n\n
Post-Op Instructions for Myringotomy and Ear Tubes<\/a>Download<\/a><\/div>\n\n\n\n
Post-Op Instructions for Tonsils and Adenoids<\/a>Download<\/a><\/div>\n\n\n\n

Allergy Resources<\/strong><\/h4>\n\n\n\n
Allergy Testing Medication Checklist<\/a>Download<\/a><\/div>\n\n\n\n
Instructions for Allergy Testing<\/a>Download<\/a><\/div>\n\n\n\n

Dizziness & Balance Disorders<\/strong><\/h4>\n\n\n\n
VNG Instructions<\/a>Download<\/a><\/div>\n\n\n\n
VNG Patient Questionnaire<\/a>Download<\/a><\/div>\n\n\n\n

Resource Articles<\/strong><\/h4>\n\n\n\n
R-5: Benign Paroxysmal Positional Vertigo<\/a>Download<\/a><\/div>\n\n\n\n

Forms & Policies<\/strong><\/h4>\n\n\n\n
Patient Registration Forms<\/a>Download<\/a><\/div>\n\n\n\n
HIPAA Privacy Notification<\/a>Download<\/a><\/div>\n\n\n\n
Parental Designation Form<\/a>Download<\/a><\/div>\n\n\n\n
Welcome Letter<\/a>Download<\/a><\/div>\n\n\n\n
Patient Registration<\/a>Download<\/a><\/div>\n\n\n\n
Review of Systems<\/a>Download<\/a><\/div>\n\n\n\n
Past Medical History<\/a>Download<\/a><\/div>\n\n\n\n
Medication List<\/a>Download<\/a><\/div>\n\n\n\n
Collection Policies and Procedures<\/a>Download<\/a><\/div>\n\n\n\n
Patient HIPAA Acknowledgement Form<\/a>Download<\/a><\/div>\n\n\n\n
Patient Medical Records Release<\/a>Download<\/a><\/div>\n\n\n\n
No Show Cancellation Policy<\/a>Download<\/a><\/div>\n\n\n\n

Consent Forms<\/strong><\/h4>\n\n\n\n
Injection Snoreplasty Consent Form<\/a>Download<\/a><\/div>\n\n\n\n
Tympanostamies Consent Form<\/a>Download<\/a><\/div>\n\n\n\n
Intratympanic Membrane Injection Consent<\/a>Download<\/a><\/div>\n\n\n\n

Referring Provider<\/strong><\/h4>\n\n\n\n
Referring Provider Letter<\/a>Download<\/a><\/div>\n\n\n\n
Referral Form<\/a>Download<\/a><\/div>\n\n\n\n
Provider Medical Records Release<\/a>Download<\/a><\/div>\n\n\n\n

Language Translation<\/strong><\/h4>\n\n\n\n
Language Interpretation Consent-English<\/a>Download<\/a><\/div>\n\n\n\n
Language Interpretation Consent-Spanish<\/a>Download<\/a><\/div>\n\n\n\n
Language Interpretation Consent-Creole<\/a>Download<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

Pre\/Post Operative Information Allergy Resources Dizziness & Balance Disorders Resource Articles Forms & Policies Consent Forms Referring Provider Language Translation<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":113,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":""},"service_tags":[],"yoast_head":"\nPatient Forms - Eastern Shore ENT & Allergy<\/title>\n<meta name=\"description\" content=\"(410) 742-1567 | Pre\/Post Operative Information Post-Op Instructions for Nasal SurgeryDownload Post-Op Instructions for Myringotomy and Ear TubesDownload Post-Op\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/easternshoreent.com\/resources\/patient-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patient Forms - 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