A Note to My Patients From WNC Ear Nose & Throat:

I apologize for leaving WNC ENT without being able to tell you!  I was not allowed to send you a letter nor take your contact information with me when I left.  Please let me know your phone number and address.  Either email me or call me.  I'd love to keep in touch!

Patient Form

You can complete the Comprehensive Case History Form in one of two ways:

Click the link at the end of this sentence to download, print, and complete by hand the Comprehensive Case History Form: PATIENT FORM Then you can mail me the form or bring it with you for your appointment.

You may also complete the same form below on-line and submit it to me via email. 

If you need help on either form, please call me and we can fill out this form together.

I need this form completed before our appointment.

Patient Case History Form

Audiologic History

Medical History

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