Helpful Forms and Instructions at Eastern Oklahoma Ear, Nose and Throat (EOENT the largest ear, nose and throat clinic in the state of Oklahoma, specializes in the diagnosis and treatment of pediatric and adult ear, nose and throat diseases, both medical and surgical.

Yale Office
5020 East 68th Street South
Tulsa, Oklahoma 74136-3356
(p) 918-492-3636
(f) 918-494-8915

SouthCrest Office
8803 S. 101st East Ave.,
Suite 110
Tulsa, Oklahoma 74133-5716
(p) 918-492-3636
(f) 918-294-9976

Please find a listing of forms and instructions below that will provide useful information to you and expedite your visit to Eastern Oklahoma Ear, Nose & Throat. These forms are in a PDF format, and you will need Adobe Acrobat to open these files. If you do not already have Adobe Acrobat installed, you can download a free version here.

Patient Registration and Authorization -mandatory- This form is part of the registration paperwork that must be filled out prior to or during yoru first visit with EOENT. This form includes insurance and contact information.

Patient Medical History -mandatory- This must be filled out during or prior to your first visit to EOENT.

Notice of Privacy Practice Acknowledgement Form - mandatory

Dizziness Questionnaire - This must be filled out during or prior to your first visit to EOENT.

Snoring/Sleep Apnea Questionnaire

Request for Release of Medical Records Form