Online Patient Forms
The ENT Institute knows that your time is valuable. To help with this, we have provided two of our patient forms online enabling you to spend less time waiting.
Simply download the form below, print it out and fill it in. Bring the completed forms to any of our Georgia locations for your appointment to reduce your wait time.
You will need Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, you may get it here.
» New Patient Form - ( PDF 86K)
» Instructions for Sleep Study - (PDF 11MB)
» Patient Rights - (PDF 78K)
» Allergy Test and Screen Consent - (XLS 58K)
» Allergy Testing Information - (DOC 70K)
» Records Release 2010 - (DOCX 70K)
Testimonials:
"I recently had endoscopic sinus surgery and rhinoplasty surgery. Dr. Gallups made me feel comfortable and confident in my decision to have surgery. He did an amazing job and the surgery went extremely well. The results are exactly what I wanted and I feel and breathe better."
- Laura B., Alpharetta, GA
In The News:
Ear, Nose and Throat News From Medical News Today
- Frequent Heartburn Increases Risk Of Throat Cancer By 78%,0,15
- Fri, 24 May 2013 - Frequent heartburn increases the risk of cancers of the throat and voc...
- Sleep Apnea Symptoms In Childhood Treated By Early Removal Of Adenoids And Tonsils,0,15
- Thu, 23 May 2013 - Adenotonsillectomy, or the removal of the adenoids and tonsils, is per...
- Outcome In Head And Neck Cancer Predicted By Genetic Diversity Within Tumors,0,15
- Tue, 21 May 2013 - A new measure of the heterogeneity - the variety of genetic mutations ...
