Preparing for Your Appointment
We want to answer as many of your questions as we can at your visit.
In order to help you prepare, please be sure to document the following information:
Date of Appointment: _____________________
Time of Appointment: _____________________
Office Location: __________________________
Phone: _________________________________
Doctor’s Name: __________________________
Be sure to bring the following items with you:
- INSURANCE CARDS
- DRIVERS LICENSE OR PICTURE ID
- COMPLETED MEDICAL HISTORY FORM
- COMPLETED FINANCIAL AGREEMENT FORM
- FORM OF PAYMENT FOR SERVICES RENDERED
- PREVIOUS MEDICAL RECORDS RELATED TO YOUR COMPLAINT INCLUDING:
- X-Ray Reports and Films
- Previous Allergy Tests
- Previous Hearing, Balance Tests
- Biopsy results, etc.
Florida Gulf Coast Ear, Nose & Throat is happy to announce that we accept the following forms of payment for your office visit:
- Visa and Master Card
- Personal Check
- Cash
New Patient Appointment Reminder
Click on the "New Patient Appointment Reminder" Link Below to Print Form.
