KYENT  | New Patient Registration

In order to help improve the quality and efficiency of your visit at Kentucky Ear, Nose & Throat, new patients can download Patient Medical Information forms and fill them out before coming in for their appointment. This will help decrease your wait time when you arrive at our office. If you elect to download and print the forms from the website, you must download each of the forms listed below (1-3).

Don't forget to schedule your appointment if you have not already done so.

• 1. (Download & Print) New Patient Application



• 2. (Download & Print) Patient Office Consent Form



• 3. (Download & Print) HIPAA Compliancy Form

Kentucky Ear, Nose & Throat thanks you for choosing us as your otolaryngological medical provider. We appreciate the confidence you have placed in us and look forward to caring for you. It is best to arrive a few minutes early to ensure your paperwork has been submitted correctly. Thank you for your cooperation, and we look forward to serving you. Kentucky Ear, Nose & Throat participates with the following insurance providers:

• Aetna
• Anthem/BlueCross BlueShield
• Humana
• Medicare
• PPO NEXT
• PHCS – Private Healthcare Systems
• CHA Health