UR Medicine / Otolaryngology (ENT) / Patient Information & Forms
Patient Information & Forms
At UR Medicine Otolaryngology (ENT), we strive to provide you with the best possible experience. Prior to your appointment, we ask that you review the following information and complete the appropriate forms.
To schedule an appointment, you or your primary care physician can call (585) 758-5700. Please note that a referral may be needed for your visit.
Our office hours are Monday through Friday from 8:00 a.m. to 5:00 p.m. We also provide same-day urgent care appointments at our Clinton Woods office, located at 2365 South Clinton Ave., Suite 200.
To schedule an urgent appointment, please have your primary care or referring physician call (585) 758-5700.
Preparing for Your Initial Appointment
If you are a new patient, please bring your completed New Patient Questionnaire with you. Please arrive at our office 10 minutes prior to your appointment to complete your registration and insurance information. Also, please remember to bring any X-rays, CT or MRI scans, lab reports and/or medical records with you if they have not already been sent to our office.
Authorization for Release/Disclosure of Medical Records
Involvement in Care Discussion Form
Health History Questionnaire
Insurance & Payment Information
If your visit requires a referral from your primary care physician, please remember to bring it with you, along with your insurance and identification cards and any applicable co-payment. We accept most major medical insurances. All co-pays will be collected at the time of your appointment. For any services provided that are not covered by your insurer, payment is expected at time of service. If you have any questions about the health plans we accept or about our payment policies, please contact our office at (585) 758-5700.
If you prefer to use a credit card to pay your bill, please use URMC’s secure online payment option.
Prior to Scheduling Surgery
If your or your child’s doctor is recommending surgery, please review the post-operative (after surgery) instructions before coming to your pre-operative appointment. This information will help guide you through the surgical process.