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New Patient Forms | Ear, Nose & Throat Clinic | oakdaleent.com

Forms

New patient forms


Patient health history

For new patients, if you prefer to take care of paperwork in advance of your first appointment, download and complete the health history form and bring it to your appointment. This provides us with important information about your health. All answers are strictly confidential and will become part of your medical record.

All patients are asked to review and sign this form that outlines our policies and confirms your consent for diagnostic procedures and medical treatment.

All patients are asked to review and sign this notice that describes how medical information about you may be used and disclosed, and how you can get access to this information.

Authorization forms


Guardian pre-authorization

For guardians of ongoing patients, this form provides advance authorization for medical care delivered to patients, without a having to be present prior to each treatment.

Release of health information and records

If it is necessary for our providers to share information with a third party, we will ask you to complete and sign this authorization before we release your healthcare information.

The following authorize Oakdale ENT or third parties to discuss or review a patient’s healthcare information with designated individuals.

Serving the Twin Cities

Three locations in the northwest suburbs of Minneapolis.