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Patient Encounter for Initial Visit Forms

Patient Authorization Form
Consent for Release of Medical information
Notice of Privacy Practices
Patient Information
Acknowledgment of Receipt of Notice of Privacy Practices
Acknowledgment Receipt
Questionnaire
Responsibility Acknowledgment

Surgical Procedure Forms

Endoscopic Surgery for Sinus Headaches
Endoscopic Sinus Surgery
Instructions Following Nasal Surgery
Instructions Following Sinus Surgery
Septoplasty with or without Partial Turbinectomy
Tonsillectomy/Adenoidectomy
Tonsillectomy/Adenoidectomy 2
Instructions Following Adenoidectomy
Instructions Following Vocal Cord Surgery
Instructions Following BMT
Myringotomy & Tube Placement
Instructions Following T & A
Hypertonic Saline Nasal Irrigation
Laryngopharyngeal Reflux
Allergy Testing

Tonsillectomy and/or Adenoidectomy
Coblation Tonsillectomy
Endoscopic Sinus Surgery
Balloon Sinuplasty
Myringotomy & Tube Placement
Septoplasty & Turbinectomy
Laryngoscopy & Biopsy
Allergy Testing
Hearing Aids
Laser Skin Rejuventation

Michael A. Olenginski, D.O. Eugene E. Stec, M.D. Louis J. Mariotti, D.O