About Your Visit

Our office staff may ask you to print and fill out one or more of the forms below. This saves you time and helps us process your paperwork faster. Please contact us directly @ 515.267.1800 with any questions on these forms.

We want to answer as many questions at your visit, please prepare for this by bringing the following information to your first visit:

• Health Insurance Card/Information
• A friend or family member to take notes/help with questions
• A list of all medications you are taking
• A list of your questions /concerns
• CT Imaging (not just the reports - get the actual films)
• Copies of records from doctors related to your sinuses/nose/allergies/lungs
• Complete forms provided below

Patient Forms

Forms Require Free Adobe Reader Software - download here if needed

	New Patient Pack (includes all forms below)
	New patient history form
	New patient insurance form
	Child medical history form
	Patient consent form
	Notice of privacy practices form

What if I live outside of Iowa?
Contact Us