Patient Forms

This page includes links to downloadable patient forms and post-op instructions. Please scroll down the page to find the form you need.

New Patient Forms

The following pdf forms are provided for your convenience to download, print and complete prior to your arrival at our office. In addition to the completed forms below, be sure to bring all insurance cards, medications, and any CT Scans or recent X-Rays with you.

Adult Medical History

Pediatric Medical History

Patient Profile

Patient Policies

Authorized Designee

Medical Records Release Form

Consent for Treatment of Minor Child

For providing Asheville Ear Nose & Throat with a list of authorized people to bring your child in for treatment.

English version

Spanish version

Surgery Patients

The following forms are provided for your convenience to complete prior to your arrival at our office. In addition to the completed forms below, be sure to bring all insurance cards, medications, and any CT Scans or recent X-Rays with you.

Adult Medical History

Pediatric Medical History

Patient Profile

Patient Policies

Authorized Designee

Audiology Patients

Please complete one of the below forms prior to your visit:

Adult Medical History

Pediatric Medical History

VNG Pre-Test Instructions

Post-Op Instructions

The following post-op instructions are provided for your convenience and reference. If the instructions you receive from your surgeon differ, follow those instead. If you have any questions or concerns, call our office at (828) 254-3517

English version:

Blepharoplasty / Facelift

Mastoidectomy / Cochlear Implant

Myringoplasty / Tympanoplasty / Stapedectomy

Myringotomy (Ear Tubes)

Nasal / Sinus Surgery

Tonsillectomy and Adenoidectomy

Spanish version:

Blepharoplasty / Facelift

Mastoidectomy / Cochlear Implant

Myringoplasty / Tympanoplasty / Stapedectomy

Myringotomy (Ear Tubes)

Nasal / Sinus Surgery

Tonsillectomy and Adenoidectomy