{"id":73,"date":"2018-09-06T20:37:19","date_gmt":"2018-09-06T20:37:19","guid":{"rendered":"https:\/\/fueldev.site\/~lomaxent\/our-practice\/patient-forms\/"},"modified":"2021-03-19T23:37:41","modified_gmt":"2021-03-19T23:37:41","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/entlv.com\/resources\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"\n

Provided on our website are various forms that require completion prior to your visit. Please download and print out either the Adult Patient Paperwork, or Pediatric Patient Paperwork, depending on the age of the patient by clicking on the name of the form, along with any Questionnaire(s) that you feel applies to your symptoms.<\/p>\n\n\n\n

Please bring in the completed form(s) with you to your scheduled visit.<\/strong><\/p>\n\n\n\n

Medical Forms<\/h2>\n\n\n\r\n\t\t\t\t\t\t\t\t\t
<\/path><\/svg> Adult Patient Paperwork<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Pediatric Patient Paperwork<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Allergy<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Dizziness<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Ear Infection<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Sinusitis<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Sleep Apnea<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Questionnaire \u2013 Tinnitus<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr><\/table>\n\n\n

Dr. Lomax Post-Op Instructions<\/h2>\n\n\n\r\n\t\t\t\t\t\t\t\t\t
<\/path><\/svg> Eustachian Tube Balloon Dialation Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Facial Fracture Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Larynx and Vocal Cord Surgery Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Nasal and Sinus Surgery instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Skin Lesions and Neck Mass Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tympanoplasty Myringoplasty<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Thyroid and Salivary Gland Surgery Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tracheostomy Care Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Wound Care<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tonsillectomy (under 12 years old)<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tonsillectomy (over 12 years old)<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Myringotomy Tympanostomy<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Neck Surgery<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr><\/table>\n\n\n

Dr. Hilton Post-Op Instructions<\/h2>\n\n\n\r\n\t\t\t\t\t\t\t\t\t
<\/path><\/svg> BAHA<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Nasal-Septoplasty-Turbinate-Sinus<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Chronic Ear-Middle Ear-Tympanoplasty<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Eustachian Tube Balloon Dialation Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Oral or Lip Lesion Removal<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Myringotomy-Tympanostomy-Ear Tube Placement<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Neck Surgery<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Laryngeal-Microsurgery-Laryngoscopy<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Removal Skin Lesions With or Without Reconstruction<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tonsillectomy And\/Or Adenoidectomy<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Thyroid or Parathyroid Surgery<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Tonsillectomy And\/Or Adenoidectomy And\/Or Uvulopalatopharyngoplasty <\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr><\/table>\n\n\n

Patient Care Instructions<\/h2>\n\n\n\r\n\t\t\t\t\t\t\t\t\t
<\/path><\/svg> Benign Paroxysmal Positional Vertigo<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Cawthorne Exercises<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Cerumen Removal and Prevention<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Epistaxis Instructions<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Facts About Migraines<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Hypertonic Saline Irrigation<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Laryngopharyngeal Reflux Disease Handout<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Planes and Our Ears<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Protecting Your Voice<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> TMJ Instructions and Hints<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr>
\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg> Wound (Postoperative) Care Instructions for Patient<\/a><\/td>\r\n\t\t\t\t\t\t\t\t\t<\/path><\/svg><\/a><\/td>\r\n\t\t\t\t\t\t\t\t<\/tr><\/table>","protected":false},"excerpt":{"rendered":"

Provided on our website are various forms that require completion prior to your visit. Please download and print out either the Adult Patient Paperwork, or Pediatric Patient Paperwork, depending on the age of the patient by clicking on the name of the form, along with any Questionnaire(s) that you feel applies to your symptoms. Please…<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":463,"menu_order":4,"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":"","locid":"","rating":"","footnotes":""},"service_tags":[],"class_list":["post-73","page","type-page","status-publish","hentry"],"yoast_head":"\nPatient Forms - Advanced Ear, Nose & Throat<\/title>\n<meta name=\"description\" content=\"(702) 834-5886 | Provided on our website are various forms that require completion prior to your visit. Please download and print out either the Adult Patient Paperwork,\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/entlv.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 - Advanced Ear, Nose & Throat\" \/>\n<meta property=\"og:description\" content=\"(702) 834-5886 | Provided on our website are various forms that require completion prior to your visit. 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