New Patient Packet

Welcome to Ohio Sinus Institute.  New patients can save time waiting in the office by downloading the Medical History Form,  Assignment of Benefits Form, Nasal Endoscopy Form, Office Billing Policy, and Acknowledgment of Receipt of the Privacy Policy.  These forms are available below.   Also, available is a map to our office.

Also, if you would like us to be able to obtain your medical records from your previous physician, please fill out the Medical Release Form so we can send this to your previous physician to obtain your records.

If you need any assistance with these forms or have any questions,  please do not hesitate to call our office (614-771-9871) during normal business hours 8-12noon and 1-5pm, EST.

Medical History Form 

Medical Release Form

Assignment of Benefits

Nasal Endoscopy Explanation

Acknowledgment of Receipt of the Privacy Policy

Office Billing Policy

Map to the Office