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Patient Forms


 

Thank you for scheduling an appointment with West Shore ENT & Allergy. Please call our office if you need to change your appointment.

Please make sure you have: 

1)   Insurance cards and copayment with you at the time of your appointments, along with photo identification. Since co-payments are a contract with your insurance company, we cannot bill for your copayment. If you do not have these your appointment will be rescheduled.

2)   Completed Registration, Health History, and Financial Policy forms. You may complete them by following the links below.

Health History

Patient Registration

Patient Financial

            NOTE:  Children (17 years or younger) MUST be accompanied
by a parent.  If legal guardian or foster-parent, you MUST bring legal document at time of visit in order to be seen.

3)    If you have had any recent testing done pertaining to your problem please bring the reports with you to your appointment. If we do not have them, your appointment may need to be rescheduled.

If you have had any imaging done please bring in the actual radiology films/CD.  You may request those from the facility where the scan was done. If your scans were done through Trinity Health  (Muskegon or Lakeshore campus) we are able to look those up and bringing films will not be necessary.   IF WE DO NOT HAVE THE DISC OF IMAGES YOUR VISIT MAY BE RESCHEDULED.

If you have Access Health, Humana or Tricare Insurance, you will need to call your family doctor to make sure that they have sent the required authorization to our office. If we do not have authorization, your appointment will be rescheduled.

You will also need to bring in a list of all current medications that you take (along with dose and directions on how they are taken), as well as any medication allergies that you may have.

 

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