Patient Forms at Southdale Otolaryngology


New patients and existing patients not seen in the office since May 24th, 2011 are encouraged to use the Patient Portal.

Please call the office at (952) 896-3166 for personalized log-in and password information in order to securely access the on-line pre-registration system.

The process takes approximately 5-10 minutes and can be completed from any computer with internet access.

This will greatly expedite your registration and check-in process on the day of your appointment.

If you do not have access to the intermet, you may print the Adult and Pediatric Patient History Form and complete this prior to your scheduled appointment.

Adult and Pediatric Patient History Form


Additional Forms

 

Please fill out these forms if asked to do so by our staff.

Records Release Form


Financial Policy Form