Patient Care

Patient Care Forms

Appointment Forms
Initial Visit - Adult (PDF: 471k)
Initial Visit - Adult: Dublin Location (PDF: 70k)
Initial Visit - Pediatrics (PDF: 471k)
Patient Information Sheet (PDF: 46k)


Consent Forms
Bone Anchored Hearing Aid (BAHA) (PDF: 88k)
Cerebellopontine Angle (CPA) Tumors / Other Unusual Tumors (PDF: 135k)
Gentamicin Injection (PDF: 86k)
Hypoglossal - Facial Nerve Anastomosis (PDF: 146k)
Middle Fossa Surgery / Facial Nerve Decompression (PDF: 134k)
Myringotomy and Insertion of Ventilation Tubes (PDF: 90k)
Resection of Base of Skull Tumors (PDF: 156k)
Retrolabyrinthine Vestibular Nerve Section (PDF: 153k)
Soft Tissue Removal (Facial Cyst) (PDF: 129k)
Stapedectomy, Tympanotomy, and Middle Ear Exploration (PDF: 126k)
Translabyrinthine Facial Nerve Decompression (PDF: 156k)
Translabyrinthine Labyrinthectomy (PDF: 156k)
Other Procedures, including: (PDF: 130k)

• Cochlear Implant
• Endolymphatic Shunt
• Meatoplasty
• Tympanoplasty
• Mastoidectomy
• Operations for Correction of Chronic Ear Infections

Pre-Operative Instructions
The Ohio State University Medical Center (PDF: 74k)
University Hospitals East (PDF: 85k)


Post-Operative Instructions
Cochlear Implant (PDF: 99k)
Ear Drum Repair / Mastoidectomy (PDF: 33k)
Ear Tubes (PDF: 88k)
Endolymphatic Sac Decompression / Shunt (PDF: 90k)
Stapedectomy / Ossicular Reconstruction / Middle Ear Exploration (PDF: 90k)
Tonsillectomy / Adenoidectomy (PDF: 95k)


Other
Financial Assistance Programs (PDF: 36k)
Privacy of Your Health Information (PDF: 37k)
Patient Education Materials


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