ENT Faculty World Class Medicine NYMC World Class Medicine

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Patient Forms

To save time during your appointment, you can fill out these forms at home and then bring them with you ALL PATIENTS must fill out the forms in the Patient Information Packet.

For Dr. Katrina Stidham patients, in addition to the patient information packet if you are experiencing dizziness, vertigo or balance problems please fill out the form below:

For Dr. Zalvan's patients,In addition to the Patient Information Packet above, please fill out the form that most fits your problem:

  • If you are having any problem with your voice, singing, or speaking, please download and fill out this form:
    Voice Questionnaire
  • If you are having any problem swallowing, throat discomfort, chronic cough, throat spasm, lump in the throat, or other problem with your throat, fill out this form:
    Swallow/Throat Questionnaire

 

Please note: These documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.