Patient Forms

Respected Ear, Nose, and Throat Physicians and Surgeons. Exceptional Skills.

Cutting-edge Treatments for Ear Nose, Throat, and Allergy. Snoring/Sleep Apnea, Sinusitis/Balloon Sinuplasty, Eustachian Tube Balloon-plasty, and Tinnitus relief.

We have recognized a glitch in our appointment software. If you receive conflicting scheduling information please contact us at 610-415-1100. We are working to resolve the issue and offer our sincerest apologies!

If you are having difficulties with our patient portal, please e-mail help@healow.com

Respected Ear, Nose, and Throat Physicians and Surgeons. Exceptional Skills.

Cutting-edge Treatments for Ear Nose, Throat, and Allergy. Snoring/Sleep Apnea, Sinusitis/Balloon Sinuplasty, Eustachian Tube Balloon-plasty, and Tinnitus relief.

Please read our COVID-19 safety measures and protocols here to ensure the health and safety of everyone.

If you are having difficulties with our patient portal, please e-mail help@healow.com

Congratulations on taking the first step to a healthier you!

Patient Forms

Patient Referral Form

New Patient Demographic Form

Review of Systems Form

Medical History Form

Notice of Privacy Practices – Acknowledgement Form

Notice of Privacy Practices

Financial Policy

Possible Same Day Allergy Testing Form

Post – Op Instructions

Submucous Reduction of Inferior Turbinates

Tonsillectomy and Adenoidectomy

Tonsillectomy and Adenoidectomy (Pediatric)

Rhinoplasty

Neck Biopsy/Skin Lesion Excision

Nasal and Endoscopic Sinus Surgery

Myringotomy and Tube Insertion (BMT)

Laryngoscopy/Esophagoscopy

Respected Ear, Nose, and Throat Physicians and Surgeons. Exceptional Skills.

Cutting-edge Treatments for Ear Nose, Throat, and Allergy. Snoring/Sleep Apnea, Sinusitis/Balloon Sinuplasty, Eustachian Tube Balloon-plasty, and Tinnitus relief.

We have recognized a glitch in our appointment software. If you receive conflicting scheduling information please contact us at 610-415-1100. We are working to resolve the issue and offer our sincerest apologies!

If you are having difficulties with our patient portal, please e-mail help@healow.com