New Patient Paperwork

Moreland ENT & Professional Hearing Services offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

Please select the correct clinic from the dropdowns below:

Ear Nose and Throat Waukesha WI Moreland ENT

  • Adult - New Patient Paperwork

    Click to Download

  • Child - New Patient Paperwork

    Click to Download

  • Communication of Health

    Click to Download

  • Authorization For Release

    Click to Download

  • Non-Surgical Financial Policies

    Click to Download

  • Consent For Treatment

    Click to Download

Hearing Loss Prevention Waukesha WI Professional Hearing Services

  • Adult Audiology History Form

    Click to Download

  • Adult General History Form

    Click to Download

  • Child General History Form

    Click to Download

  • Financial Policies

    Click to Download

  • Release of Information Request Form

    Click to Download

  • Phone Request Form

    Click to Download

  • Consent for Treatment

    Click to Download

  • Resound Loss/Damage

    Click to Download

  • Phonak Loss/Damage

    Click to Download

  • Oticon Loss/Damage

    Click to Download

  • Starkey Loss/Damage

    Click to Download

  • Privacy Policy

    Click to Download

OFFICE HOURS

Monday
8:00am - 5:00pm

Tuesday
8:00am - 5:00pm

Wednesday
8:00am - 5:00pm

Thursday
8:00am - 5:00pm

Friday
8:00am - 5:00pm

Saturday & Sunday
Closed

Moreland ENT

1111 Delafield St UNIT 102
Waukesha, WI 53188

(262) 547-1614

Professional Hearing Services

1111 Delafield St #102A
Waukesha, WI 53188

(262) 549-5150