our philosophy
"We strive to provide the highest quality of patient care in a professional and compassionate environment"

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PATIENT FORMS
Accelerate the check-in process by printing out and completing forms.
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Texas ENT now offers the ability to pay your bill online....
                                               

Patient Forms

New Adult Patient Enrollment Packet

New Pediatric Patient Enrollment Packet

Dizzy Questionnaire (Complete only if you are coming in for dizziness)

Sleep History Questionnaire (Complete only if you are coming in for a sleep disorder)

Texas Ear Nose & Throat Specialists, LLP wants to make your visit to our office as smooth as possible.  In order to do so it is important for us to gather relevant information about you, your insurance coverage,  and your reason for visiting us.  This is accomplished by completing several forms and obtaining your signature. 

New patients should arrive 15-30 minutes prior to their scheduled appointment time with the completed new patient paperwork. Please be prepared to provide your driver’s license, insurance cards, and any required insurance referral or authorization. Please bring a list of your current medications and any records applicable to your office visit including recent CT scans, labs, x-rays or sonograms.

New Patient enrollment packets are available below for you to print.  Please complete all pages in the packet and bring them with you to your appointment. 

Delays are sometimes unavoidable. We strive to see patients promptly as scheduled, but emergencies are inevitable and can cause unplanned delays. 

 

 

   
THREE CONVENIENT LOCATIONS SERVICING TWO MAJOR HOSPITALS & SURGERY CENTERS
     
Harris HEB Center
1615 Hospital Parkway, Suite 210
Bedford, Texas 76022
Ph: 817-540-3121  FAX: 817 355-4532
Business Office Location
Baylor Grapevine Professional
Office Building
1600 W. College Ave., Suite 270
Grapevine, Texas 76051
Ph: 817-540-3121   FAX: 817 421-6728
Watermere Medical Plaza
2813 W. Southlake Blvd.
Southlake, Texas 76092
Ph: 817-421-6700
FAX: 817 421-6757