Columbus Otolaryngology Clinic

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Brochure Index of American Academy of Otolaryngology

 

Contact Us

 

Credentials of Dr. Novotny

 

Ear, Nose & Throat (Otolaryngology) Procedures

Care After Ear Surgery

PDF Care of Your Ear After Myringotomy

 

PDF Other Care Following Ear Operations

Care After Nasal Surgery

PDF Care Following Nasal Surgery

Care After Tonsillectomy

PDF Care Following Tonsillectomy

Education for Patients

Nasal Washes - Instructions

PDF Instructions for Nasal Washes

HIPAA: Notice of Privacy Practices

PDF HIPAA Form

Insurance Companies

 

Locations of Clinics

PDF Clinic Layout

 

PDF Columbus Map

 

PDF Hospital Layout

New Patient Registration

Download Forms - Windows ME, 98 & 95

PDF Forms for Adults - Accident

PDF Forms for Adults - No Accident

PDF Forms for Minors - Accident

PDF Forms for Minors - No Accident

PDF Instructions

Download Forms - Windows XP & 2000

PDF Forms for Adults - Accident

PDF Forms for Adults - No Accident

PDF Forms for Minors - Accident

PDF Forms for Minors - No Accident

PDF Instructions

Fill Out Forms Online & Print

PDF Forms for Adults - Accident

Step 1 of 9 - Registration Form

Step 2 of 9 - Patient History Form, Part 1

Step 3 of 9 - Patient History Form, Part 2

Step 4 of 9 - Injury Report Form

Step 5 of 9 - Auto/Home Insurance Form

Step 6 of 9 - Patient Consent Form

Step 7 of 9 - Notice of Privacy Practices

Step 8 of 9 - Patient Registration Checklist

Step 9 of 9 - Final Instructions

PDF Forms for Adults - No Accident

Step 1 of 7 - Registration Form

Step 2 of 7 - Patient History Form, Part 1

Step 3 of 7 - Patient History Form, Part 2

Step 4 of 7 - Patient Consent Form

Step 5 of 7 - Notice of Privacy Practices

Step 6 of 7 - Patient Registration Checklist

Step 7 of 7 - Final Instructions

PDF Forms for Minors - Accident

Step 1 of 9 - Registration Form

Step 2 of 9 - Patient History Form, Part 1

Step 3 of 9 - Patient History Form, Part 2

Step 4 of 9 - Injury Report Form

Step 5 of 9 - Auto/Home Insurance Form

Step 6 of 9 - Patient Consent Form

Step 7 of 9 - Notice of Privacy Practices

Step 8 of 9 - Patient Registration Checklist

Step 9 of 9 - Final Instructions

PDF Forms for Minors - No Accident

Step 1 of 7 - Registration Form

Step 2 of 7 - Patient History Form, Part 1

Step 3 of 7 - Patient History Form, Part 2

Step 4 of 7 - Patient Consent Form

Step 5 of 7 - Notice of Privacy Practices

Step 6 of 7 - Patient Registration Checklist

Step 7 of 7 - Final Instructions

PDF Instructions

Print Forms & Fill Out Manually

PDF Forms for Adults - Accident

PDF Forms for Adults - No Accident

PDF Forms for Minors - Accident

PDF Forms for Minors - No Accident

PDF Instructions

 

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...

Link to Online Patient Registration Page

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Online Patient Registration

Link to HIPAA Page of Columbus Otolaryngology ClinicLink to State of Nebraska HIPAA Web Site

Home Page Locations Novotny, M.D. Procedures Education

 

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