PHOTO ID

COMPLETED REGISTRATION FORMS

HEALTH INSURANCE CARD & YOUR CoPAY

MEDICATIONS; PRESCRIPTIONS, OVER-THE-COUNTER, AND "HERBAL SUPPLEMENTS"

COPIES OF YOUR PAST MEDICAL RECORDS AND/OR IMAGING AS IT RELATES TO YOUR EARS, NOSE, AND THROAT. IF THESE DOCUMENTS HAVE BEEN OBTAINED PREVIOUSLY OR ELSEWHERE, WE WOULD APPRECIATE YOUR ACQUIRING THIS INFORMATION FOR OUR REVIEW.