Patient Registration Forms

Main Line Ear, Nose & Throat of Paoli welcomes you to our practice. Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician. Completing the forms prior to your visit will help speed up the new patient registration process.

Downloadable Forms:

• New Patient Registration & Health History
• Authorization to Release Protected Health Information
• General Consent

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.