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Patient Forms

Get started with your visit beforehand with these convenient online patient forms. You can download them, print, and fill them out before bringing them to your appointment.

Registration

Patient Registration

Adult Medical History Form

Pediatric Medical History Form

Minor Consent Form

Surgery

Post-op Instructions – Myringotomy/Tubes

Post-op Instructions – Tonsillectomy and/or Adenoidectomy

Post-op Instructions – Nasal Septoplasty

Post-op Instructions – Ear Operation

Post-op Instructions – Nasal Surgery

Other

Authorization to Release/Obtain Medical Records

Hearing Aid Assessment

Auditory Brainstem Response Testing (ABR) Instructions

Audio ENG / VNG Pre-Test Instructions

Dizziness Questionnaire

Snoring Questionnaire

Patient Financial Policy

Having trouble viewing the forms?  Download Adobe Reader from the Adobe website.

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Our COVID-19 Safety Protocol at ENTSC

Ear, Nose, & Throat Specialty Care of Minnesota (ENTSC) remains committed to the health and safety of our patients and our staff. For that reason, we’re sharing the following information:

  • – Our clinics remain open, but with increased safety and sanitary routines
  • – Those with “Non-Emergent” appointments may be asked to be rescheduled to aid in social distancing
  • – We urge those with symptoms or exposure to illness to call to re-schedule your appointment

We are here to help! Please find all information about our clinic’s COVID-19 response on our News Page.

 

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