Instructions & Forms

ENT Specialists

Forms, Hours and Location Maps

Before Your Visit

Please complete the following forms. Having this information completed before arriving will help to ensure that you get in to your scheduled appointment time without any delays.

If you wish to complete the form online, click the Online Form link next to the form. Click Submit to send the form electronically over a secured connection.

If you wish to mail in your forms, click the Download Printable PDF link next to the form. Print, fill out the information and mail the form to our main office:

Northside ENT
ATTN: Scheduling
12065 Old Meridian, Suite 205
Carmel, IN 46032

NEW Patients, please fill out the following forms for prior to your visit.

* Patient Information Sheet Download Printable PDF (3.3MB) // Complete Online form
* Patient History Download Printable PDF (3.3MB) // Complete Online form
* Medical History Download Printable PDF (100K PDF) // Complete Online form

-----Please print, sign and bring the following forms with you to your visit-----
* Consent Form Download Printable PDF (100K PDF)
* Financial Policy Download Printable PDF (260K PDF)

RETURNING patients that have moved or changed insurance providers), Please fill out the Patient Information Sheet

* Patient Information Sheet Download Printable PDF (3.3MB) // Complete Online form

Special Procedure Instructions

* Post-Operative Ear Surgery Download Printable PDF(38K PDF)
* Post-Operative Nasal Surgery Download Printable PDF(39K PDF)
* Pre-Operative Instructions for Tonsillectomy Download Printable PDF(45K PDF)

HIPAA

* Notice of Privacy Practices Download Printable PDF(40K PDF)

Schedule an Appointment

To schedule or change an appointment with one of our physicians, please contact one of our scheduling specialists at (317) 844-5656 or 1-800-556-5456.

If you would like to have a scheduler call you to make or change your appointment, please email us and someone will be in touch with you.
scheduling@northsideent.com