Patient Forms


 

To access our forms to print and fill out prior to your appointment, click the appropriate links below.


MEDICAL RECORDS TRANSFER. If you need to transfer your medical records to or from our office, please click on THIS FORM, fill it out and return it to the office that has your original records.


IMPORTANT INFORMATION REGARDING MINORS AND OTHERS WITH LEGAL GUARDIANS:

At Petoskey Ear, Nose & Throat Specialists, we take our responsibilities very seriously regarding treatment of minors and other patients who are not responsible for themselves. We have important information for anyone responsible for either of these important people whether as parents, foster parents, relatives or legal guardians. Someone legally responsible for our patient must be in attendance at every appointment in our office to provide medical information, insurance and billing information, and most importantly, consent for the treatment to be provided. Please review the following information regarding Legal Guardians then download whatever additional form may be needed if the parent or other legal guardian will not be present for the appointment. We are not able to accept hand-written notes or phone calls in lieu of these important legal documents.


Privacy Policy

Petoskey Ear, Nose & Throat Specialists values the right to patient privacy for all medical care. We will protect your information and hope that you understand our need to adequately verify identification of all persons requesting information or access to medical records. Our full Privacy Policy can be found in the link below:

Download Our Privacy Policy

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