Forms

Before you come for your office visit:

ALL new patients should download & complete the following two forms. If possible, email completed forms to patientcare@entcarepc.com.

Intake Form: PDF

ALL patients should print and read this document:

Patient Privacy Policy Notice: PDF

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

Allergy Questionnaire: PDF

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 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)

Before you come for your office visit:

ALL new patients should download & complete the following two forms. If possible, email completed forms to patientcare@entcarepc.com.

ALL patients should print and read this document:

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

Visit Us

Before you come for your office visit:

ALL new patients should download & complete the following two forms. If possible, email completed forms to patientcare@entcarepc.com.

ALL patients should print and read this document:

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