Thank you for continuing to see our physicians at the Southern New England Ear, Nose, and Throat and Facial Plastic Surgery Group, LLP for your medical needs.
If you have not been seen within the past 12 months, we do need you to complete the forms below prior to your visit.
Also, if there have been any changes (i.e., address, insurance, etc), we need the forms completed.
If you have not been seen within the past 12 months, we do need you to complete the forms below prior to your visit.
Also, if there have been any changes (i.e., address, insurance, etc), we need the forms completed.
Click to fill out patient forms:
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To make your visit as efficient as possible,
please remember to bring the following with you:
1. A copy of your insurance card
2. a listing of your current medications and allergies
3. your copay (check, cash, or credit card accepted).
4. a photo ID (driver license, CT. state ID, passport....)
Thank you for your cooperation.
Copays are expected at the time of visit. We accept all credit cards.
Please note our CANCELLATION and NO SHOW Policy, effective February 15, 2017.
If you cannot make your scheduled appointment, please call 203-787-4951 at least 24 hours before the appointment.
There will be a $25 charge for missing your appointment without a 24 hour notification call.
Patients who NO SHOW three or more times in a 12 month period may be dismissed from the practice.
Thank you for your understanding and cooperation. SNEENT Management
Copagos se espera en el momento de la vista aceptamos todos las tarjetas de credito.
Gracias, SNEENT de gestion
please remember to bring the following with you:
1. A copy of your insurance card
2. a listing of your current medications and allergies
3. your copay (check, cash, or credit card accepted).
4. a photo ID (driver license, CT. state ID, passport....)
Thank you for your cooperation.
Copays are expected at the time of visit. We accept all credit cards.
Please note our CANCELLATION and NO SHOW Policy, effective February 15, 2017.
If you cannot make your scheduled appointment, please call 203-787-4951 at least 24 hours before the appointment.
There will be a $25 charge for missing your appointment without a 24 hour notification call.
Patients who NO SHOW three or more times in a 12 month period may be dismissed from the practice.
Thank you for your understanding and cooperation. SNEENT Management
Copagos se espera en el momento de la vista aceptamos todos las tarjetas de credito.
Gracias, SNEENT de gestion