Forms

FORMS:

(click to open in PDF) please fill form A and one the B forms based on patient's age :

 

A - Patient Registration Form

 

 

Patient registration
Patient Registration.pdf
Adobe Acrobat document [459.0 KB]

 

 

B-  Medical history form 

 

1- Medical history form - Adult
Medical History- Adult.pdf
Adobe Acrobat document [226.5 KB]
2- Medical history form - Pediatric ( 5-18 years )
Medical History- age 5-18.pdf
Adobe Acrobat document [148.9 KB]
3- Medical history form - Pediatric ( 0-5 years )
Medical History- age 0-5.pdf
Adobe Acrobat document [152.6 KB]

What is nasal endoscopy?

Nasal endoscopy is a procedure to look at the nasal and sinus passages. It’s done with an endoscope. This is a thin, rigid or flexible tube with a light. An ear, nose, and throat doctor (otolaryngologist) will often do this procedure in his or her office to look inside the nose and check on the sinuses, congestion , septum , adenoids or polyps. The procedure is relatively quick and painless. Your doctor will sometimes distract you with small talks to alleviate anxiety associated with the procedure to make it quick . Sometime the doctor will spray your nose with medication to numb your nose if the insertion of the scope is difficult or painful. Sometimes the scope is attached to a camera to records videos as part of your records . The information gathered from this quick procedure is very valuable to check the current status, improvement on treatment and for decision making on different treatment options like surgery .

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