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To Print These
Instructions, Click Here...
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1. Please make sure your printer is
turned on and has paper. |
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2. The Patient Registration Forms work
best in Adobe Acrobat Reader 5.0 or better. To download a
free copy, click on the icon below... |
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3. Older & non-standard web
browsers sometimes have difficulties with on-line forms. If that
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out with pen or pencil. To do so, click here... |
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4. Select an
appropriate option shown below... |

| Option #1 |
| Adults
(Patients 19 and over) - Not due to
Accident or Injury |
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| Option #2 |
| Adults
(Patients 19 and over) - Due
to Accident or Injury |
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| Option #3 |
| Minor
(Patients 18 and under) - Not due to
Accident or Injury |
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| Option #4 |
| Minor
(Patients 18 and under) - Due to Accident or Injury |
 |
Columbus Otolaryngology Clinic
Nila
M. Novotny, M.D.
4508
38th St., Suite #152
Columbus, NE 68601-1668
402-563-4500 FAX: 402-563-3520
After
Hours/Emergency 402-562-3179
To Contact Us, Click Here...
 
 

by McGee Designs,
1999-2010
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