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Province South Seattle Otolaryngology Allergy Intake Questionnaire Patient name: DOB: Today's Date: 1. PATIENT HISTORY a. When did your allergy symptoms begin (please mark one): Infancy Childhood
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Anyone requiring medical care related to the ear, nose, or throat (ENT) may need the services of Proliance South Seattle Otolaryngology. This can include individuals suffering from conditions such as chronic sinusitis, allergies, throat infections, hearing loss, tonsillitis, voice disorders, or nasal obstructions. Additionally, individuals seeking specialized care for head and neck cancers or facial plastic surgery may also benefit from the services provided by Proliance South Seattle Otolaryngology.
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Proliance South Seattle Otolaryngology is a medical clinic specializing in the diagnosis and treatment of ear, nose, and throat (ENT) conditions.
Patients who receive services or treatments from Proliance South Seattle Otolaryngology may be required to file certain forms for insurance or medical records purposes.
To fill out the required forms for Proliance South Seattle Otolaryngology, visit their website or contact the clinic for specific instructions and downloadable forms.
The purpose of Proliance South Seattle Otolaryngology is to provide specialized medical care for patients with conditions affecting the ear, nose, throat, and related structures.
Patients must report their personal health information, medical history, current medications, and any specific symptoms related to ENT concerns.
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