Thank you for choosing Mid-Kansas Ear, Nose & Throat Associates. For your first office visit, you will need to complete some new patient forms. For your convenience, you can print off the forms below from home, complete them and then bring them to your first appointment.

New Patient Information Form (English)

New Patient Information Form (Spanish)

Medical History Form (English)

Medical History Form (Spanish)

HIPAA Authorization Form (English)

HIPAA Authorization Form (Spanish)