For Patients
Patient Forms
Prior to your appointment, the clinic administrative staff will contact you and ask you to download and complete one or more of the following forms.
For all patients
- Clinic Policies
- Telehealth Informed Consent
- Demographic Questionanaire
- Directions
- Parking
- Cancellation Policy
Notices for all patients
- Hearing Clinic Notice of Nondiscrimination
- USF Health Notice of Nondiscrimination and Accessibility Requirements
- Joint Notice of Privacy Practices
Forms for Pediatric Patients
- Newborn Case History (0 - 3 months)
- Infant Case History (3 - 6 months)
- Pediatric Case History (6 months - 17 years)
- Consent for Treatment and Care of Minors