Patient Forms & Info

New Patient Packet

New Patients or patients who have not been seen in the last 3 years, get the forms here:

Please Note: As of October 1, 2013 HIPAA (Health Insurance Portability and Accountability Act) has made some changes state-wide.  Due to the changes, our paperwork and forms are longer and more time consuming.  Please print your paperwork to fill out before your appointment, or plan to arrive 30 minutes earlier then your scheduled appointment time.

For questions concerning HIPAA, please read the below attachment.  If you have additional questions, you may contact our office anytime at 704-896-1909.

If you would like your records released to another doctor, or need to send us records from a previous doctor or primary care doctor, please fill out the below form:

If you are being seen for a hearing loss or hearing device please complete and bring the below form with you to your appointment.

South Lake Ear Nose And Throat

9710 Sam Furr Rd. Suite D. Huntersville, NC 28078  

Phone: 704-896-1909   Fax: 704-896-1926 

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