Spokane Valley Ear, Nose and Throat and Facial Plastics


Spokane Valley Ear, Nose and Throat has a full staff of doctors who are all board certified.
Omar Husein, M.D. / Geoffrey G. Julian, M.D. / Charles F. Benage, M.D. / G. Bruce McClelland, M.D. / Eric B.Leavitt, M.D.  
 


Patient Portal

Please print and complete the forms below and bring with you to your appointment
 

New Patients

Existing Patients

New Patient Letter
Financial Policy
New Patient History  (Complete for all patients)
Adult Patient Information
Privacy Practices Acknowledgement

Minor Patient Information (Under 18)
Advance Consent to Treat  Minors
 

Adult Patient Information
Minor Patient Information (Under 18)

Patient History

 

 

Release of Records Form

Notice of Privacy Practices
 

MedicalFinancing.com
 

about / our doctors surgical information / spokane valley ambulatory surgery centerallergies / audiology /  facial plastics / billing / contact us
 

Copyright 2013
Spokane Valley Ear, Nose & Throat, P.S.
1424 N. McDonald Rd., Suite 101
Spokane, WA  99216
509-928-7272 Main Office
509-340-8340 Spokane Ambulatory Surgery Center
509-928-7346 Fax

 

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