Ear Nose & Throat Logo outlined_175Ear Nose and Throat Care PCPatients In Doctors Waiting Room

DAVID BORTNIKER, MD
HOWARD DRUCE, MD

908-704-9696

 

Forms

Before you come for your office visit: 

Please register on-line now.

ALL new patients should download, complete and print the following two forms

General Information Form:     General Information Form

Medical History:                     Medical history

 

ALL new ALLERGY patients should also download, complete and print this form

Allergy Questionnaire:            Allergy Questionnaire

 

ALL patients should print and read the

Patient Privacy Policy Notice:    Patient Privacy Policy Notice

 

If you do not have the completed forms with you, please come to the office at least 15 minutes before your appointment to complete paperwork

 

Please bring your insurance card and photo ID

 

NJ-lic

We accept Medicare and most major insurance plans including:

 

Medicare, Worker’s Compensation, Aetna (HMO), Aetna (PPO), Cigna (HMO), Cigna (PPO), Coventry Health Plan, TriCare (Old Champ Prime), United Healthcare, Consumer Health Network, Great West, Managed Health Network, First Health, PHCS, Choice Care Network, QualCare (Network), Health Net, Multi-Plan, AmeriHealth (HMO), AmeriHealth (PPO), Horizon BC/BS, Beech Street, Health Payors Organization (PPO)