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Oregon Toledo

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Patient Medical History			Click on the icon to download

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We would like to take this time to welcome you to . Thank you for choosing E.N.T. Physicians for your specialty care needs. We look forward to meeting you and providing you with the best possible medical care. To help make your first visit with us as smooth and hassle free as possible please read all of the following information.

There are several very important things to be done and made aware of prior to your visit:

• Many insurance plans require referral and pre-authorization for specialist care. Please request your primary care physician’s office to complete this prior to your appointment. If it is not in place, we will have to reschedule your visit. Verify with the insurance card, or call your insurance company, if you do not know.

• Bring, or have your physician fax pertinent medical information that may help the specialist provider give you the best possible care: medical notes, x-ray reports or actual films, sleep studies, etc.

• If your insurance plan requires a co-pay for office visits, you will be expected to pay this at the time of your appointment. Verify with the insurance card, or call your insurance company, if you do not know. We accept cash, personal checks or MasterCard/Visa for your convenience. We will not bill a secondary insurance for a co-pay. If you do not have healthcare insurance, you will be expected to pay for services at the time of the visit.

• Please by advised that it is the responsibility of the patient to check with the insurance company to make sure our company is on your insurance plan.

• Complete the medical history and information forms and send them to the office or bring them with you on the day of your appointment. Also, bring the current primary/secondary insurance cards. Please keep this information updated with us.

Download Patient Registration and Patient Medical History forms to fill out and bring with you.

We make every attempt to schedule patient appointments with the most appropriate provider in the preferred location in a timely way to meet your health care needs.

• If you must cancel an appointment, please give us at least 48 hours whenever possible so that we can offer that time to another patient.

• If you do not call or show for a booked appointment, you are wasting valuable provider time and denying other patients in need of a more timely appointment. Several no calls/no shows may result in the discharge from the practice.

If your ENT provider orders medication for you as part of your medical treatment, you or your pharmacist may call us for refills as appropriate and approved by your provider. Please call us at least 5 days prior to a refill need.

• Your ENT provider will not refill medications prescribed by your PCP or other physicians that are not pertinent to your ENT condition.

• If you are on long-term medication therapy, refills will not be authorized beyond one year without a return visit/evaluation by your ENT provider.