• Menu
  • Directions
  • E-Mail Us
  • Call Us
  • Home
  • About Us
  • Services
  • New Patients
  • Patient Portal
  • Patient Forms
  • Insurance Coverage
  • Facial Plastic Surgery
  • Patient Education
  • Patient Information
  • Testimonials
  • Blog
  • Contact Us
CALL US TODAY!
(805) 614-9250
SCHEDULE YOUR
APPOINTMENT
(805) 614-9250
  • Home
  • About Us
  • Services
    • Ears
    • Nose & Sinuses
    • Throat & Voice
    • Sleep
    • Audiology & Hearing Aids
    • Allergy
    • Facial Aesthetics
    • Head/Neck
  • Education
  • Resources
    • New Patients
    • Patient Portal
    • Patient Forms
    • Insurance Coverage
  • Blog
  • Contact Us

Patient Forms

New Patient Forms

Adobe PDFNew Patient Registration Form

Sleep Forms

Adobe PDFSleep Questionnaire
Adobe PDFSleep Questionnaire (Spanish)
Adobe PDFEpsworth Sleepiness Scale
Adobe PDFEpsworth Sleepiness Scale (Spanish)
Adobe PDFOCST Consent Form
Adobe PDFOCST Consent Form (Spanish)
Adobe PDFPediatric Sleep Questionnaire
Adobe PDFPediatric Sleep Questionnaire (Spanish)
Adobe PDFPSG Instructions
Adobe PDFPSG Instructions (Spanish)
Adobe PDFSleep Referral Form
Adobe PDFSwiss Narcolepsy Scale

Allergy Forms

Adobe PDFWhat To Expect During Your Allergy Test
Adobe PDFAllergy testing information and consent form
Adobe PDFMedications to stop prior to allergy skin testing
Adobe PDFInstructions for Sublingual Immunotherapy (SLIT) Administration
Adobe PDFSublingual Immunotherapy Pricing

Audiology Forms

Adobe PDFDizziness Questionare
Adobe PDFDizziness Questionare (Spanish)
Adobe PDFVNG Instructions
Adobe PDFVNG Instructions (Spanish)
Adobe PDFHearing Aid Drop Off Form

Surgical Forms

Consent Forms

Adobe PDFBlood Transfusion
Adobe PDFBlood Transfusion (Spanish)

Post-Op Instructions

Adobe PDFPostop Septorhinoplasty
Adobe PDFPostop Tonsillectomy

SERVICES & TREATMENTS

  • Ears
  • Nose & Sinuses
  • Throat & Voice
  • Sleep
  • Audiology & Hearing Aids
  • Allergy
  • Facial Aesthetics
  • Head & Neck

Patient Resources

  • New Patients
  • Patient Portal
  • Patient Forms
  • Insurance Coverage

Contact Us

Logo
116 South Palisade, Suite 206 Santa Maria, CA 93454
Copyright Central Coast Otolaryngology © 2016. All Rights Reserved. Medical Website Design & Marketing by Omni Medical Marketing.