Practice Forms
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Medical Release of Information Form This form will need to be completed to have outside records sent to Riviera ENT. |
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New Patient Complete Information packet If you do not want to complete the requested information directly on the portal, you can print out this packet, and send completed forms by email to info@rivieraent.com or fax to 805-679-5183. |
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Return Patient Update Form This is what to fill out on the day of your appointment to alert us to changes in your health or other details. You can bring with you or send to info@rivieraent.com or fax to 805-679-5183. IT CAN'T BE DONE ON THE PORTAL. |
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Preauthorization to Treat Minors This will need to be completed, or similar paperwork provided, for a minor child to be treated in the absence of their parent or legal guardian's presence. |
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Notice of Privacy Practices This is our Notice of Privacy Practices that discusses how medical information may be used and how you can gain access to this information. |
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New Patient Current Problems Form This is a single form that will need to be printed and completed for all new patients. You can bring it with you or send to info@rivieraent.com or fax to 805-679-5183. IT CAN'T BE DONE ON THE PORTAL. |