Your Appointment & Forms
Before your first appointment, please download and fill out your medical forms. You may also call our office to mail you these forms.
We only see patients on an appointment basis. If you need to cancel your appointment, please notify our office 24 hours in advance. We reserve the right to charge for appointments, procedures and surgeries cancelled or broken without 24 hours advance notice.
- Patient Information
- Financial Policy
- Notice of Privacy Practices
- In Office Procedure Agreement
- Health History
- Current Symptoms
- OCHNS Patient Partnership Plan
Annual Patient Updates
Please bring any relevant medical records with you, including:
- Prior hearing tests
- Recent lab results
- Prior MRI or CT scan reports and images
Insurance and Payment
We verify your insurance prior to your appointment. You will be responsible for any co-payment, co-insurance or deductible at the time of your visit. If you do not have insurance, please be prepared to pay in full for your services. Our office accepts cash, checks, Visa and MasterCard. We also offer CareCredit for patients who desire a payment plan for services.
Orange Coast ENT Head and Neck Surgery is a contracted provider with the following insurance plans:
- Blue Cross
- Blue Shield
- Health Net
- United Healthcare
HMO Plans (referral required)
- Hoag Affiliated Physicians