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Lake Ear, Nose, Throat & Facial Plastic Surgery

Leesburg: 352-728-2404
Tavares: 352-343-7279
The Villages: 352-753-8448

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This section of our web site is provided by Lake ENT to help make your first and subsequent visits as easy, as efficient and as accurate as possible. This section enhances the patient-physician relationship by giving you 24 hour access to patient specific instructions, forms and communication tools.

Forms

  • If you are a new patient or a returning patient that has not been seen in the past three years, please fill out the New Patient Information Form and the New Patient Symptom Form.
  • Existing patients, please fill out the forms appropriate to your visit or as instructed by our staff at the time you booked your appointment.


You may either fill out the form online by clicking the link below, print and bring to your appointment or, feel free to print and complete your forms by hand as completely and accurately as possible and bring them to your visit.


 Lake ENT FPS New Patient Forms Packet (v6.16)

Please note: Forms are in Adobe Acrobat format. If you do not have Adobe Acrobat Reader on your computer, please click here to download the free Adobe reader.

If you have been referred by a physician to our office, obtaining copies of your lab results or x-ray studies can expedite your visit.

Information Sheets

Lake ENT FPSOffice Policies/Fee Payment
Lake ENT FPSPrivacy Statement
Lake ENT FPSPre-Op Guidelines
Lake ENT FPSPost-Op Guidelines(Nasal Surgery)
Lake ENT FPSPatients Rights and Responsibilities

If you need assistance, please do not hesitate to call our office at (352) 728-2404.

Insurances Accepted as of January, 2017

  • Medicare
  • Blue Cross/Blue Shield
  • Aetna
  • Cigna
  • First Health Network
  • CarePlus
  • Humana
  • Optimum
  • Staywell (Lake & Sumter Counties ONLY)
  • WellCare
  • Freedom Health
  • Great West
  • Health Choice
  • Multiplan
  • PHCS
  • United Healthcare

 

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