Patti Huang, MD, FACS

Frisco's Ear, Nose, and Throat Specialist

Home     About Us     Contact Us     Services     Forms     Patient Information     Insurance Plans     Medical Information     Surgical Information     Kid's Space     Links      

Forms

We offer a number of forms in PDF form. Filling out these forms prior to your office visit can save you time.

New Patient Information   
    These forms contain general information about office policies, as well as personal and medical history, insurance information, consent to treat, and the HIPAA Notice of Privacy Policies.

New Patient Information

Consent to Treat
        This authorizes us to care for you.  For pediatric patients, this allows us to care for your child. It also allows parents to designate a third party who may give consent in the parents' absence.

Transfer in

        This is how we obtain your old medical records from previous or referring physicians' offices.

Transfer out
        This form allows us to release your medical records to another physician or if your relocate from the area.

Practice Policy/Acknowledgement
        This contains information regarding our HiPPA policies.

 

Financial Policy