Patient Forms

For the convenience of our patients, many of the forms required for your first office visit are available here. Please download and fill out the New Patient Information form and bring it to your first appointment. This will greatly expedite the process of registering you as a patient. Please arrive at least 10 minutes early to complete the registration.

Also, if you are a continuing patient and your information has changed, you may fill out a new form for your next office visit.

These forms are all available in the
Adobe Reader® format

If you don't have Adobe Reader on
your computer, please click here
for a free download

New Patient Information Records
Release
Privacy
Notice
Click on any image above to download the form


Quinn Ear, Nose and Throat 
25 Lake Concord Road  •  Concord, North Carolina 28025  •  704-782-6673  •  Fax 704-782-6605
1933 Jake Alexander Blvd., Suite 101  •  Salisbury, North Carolina 28147  •  704-637-3778  •  Fax 704-637-0995