Ear, Nose, Throat & Allergy

If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the clinic staff in ensuring that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment. 

​

REGISTRATION FORMS

• Medical Record Release

• Patient HIPPA Acknowledgement and Consent

​

SPECIALIST FORMS

• Dr. Ninh Nguyen - New Patient Form

​

PATIENT RIGHTS & RESPONSIBILITY

We respect our patient's dignity and pride. This document will explain your patient's rights and responsibilities. It is part of your registration and is an important part of your healthcare plan.

• Notice of Privacy Practices