Patient Forms

Patient Forms

Forms with this icon can be filled out online and printed or you can simply print the form and fill it out with a pen. All forms on this site require a PDF viewer or compatible browser to view and print. If needed, you can download Adobe Reader free at http://get.adobe.com/reader/.
 

New Patient Information Sheet
New Patient Information
Patient Consent Form
Patient Consent, Payment Policy, & Privacy Practices
Health Questionnaire
Health Questionnaire
Request for Records Release Form
Request for Records Release
 

External Links

American Medical Association
American Academy of Otolaryngology Head & Neck Surgery
American Academy of Facial Plastic & Reconstructive Surgery
Utah Medical Association
Fellow of American College of Surgeons
Huntsman-Intermountain Cancer Care