For Patients - Office Resources

Dallas Ear Institute welcomes you to our patient section. Please take the time to review the New Patient Preparation and options to download, print and complete our New Patient forms.

About Your Visit

What should you bring to your appointment
We want to make your visit as beneficial for you as possible. Please prepare for this by bringing:

• Health Insurance Card/Information
  
• Drivers license or picture identification
  
• If needed, a friend or family member to take notes/help with questions
  
• A list of all medications you are taking
  
• A list of your questions /concerns
  
• A copy of your imaging films or CD and copies of reports
  
• Copies of records from doctors related to your visit with us
  
• Completed NEW PATIENT FORMS PACK papers
• Secure Patient Portal - Log in or create your patient account
  Click here to enter our secure patient portal - We invite you to log in to your online account or create a new online account. Take advantage of the online services offered by our practice with the assurance that all of your information is encrypted and stored securely.

Please arrive 30 minutes early to your first appointment. *Please feel free to call our staff for directions. We can send them via e-mail, fax them to you or give them to you over the phone.

Payment is due at the time of service. Your portion (including deductible, co-pay, or patient percentage) is determined by your insurance company. Please contact your insurance company if you have any questions regarding your financial responsibility as outlined in your policy.

Financial Policy

Thank you for choosing us as your health care provider. We are committed to your treatment being successful. Please understand that payment of your bills is considered a part of your treatment. The following is a statement of our financial policy, which we require you to read, agree to and sign prior to any treatment. Dr. Peters, Dr. Hahn and Dr. Dansby render only services that, in their best professional judgment, is needed to provide quality medical care for you.

Download Dallas Ear Financial Policy

Patient Forms

Welcome to our Patient Portal

We invite you to log in to your online account or create a new online account. Take advantage of the online services offered by our practice with the assurance that all of your information is encrypted and stored securely.

In our patient portal you can:

• Update your address, phone, e-mail address, insurance and other patient information.
  
• Change your password.
  
• Add and update your credit card information.
  View a history of your previous online visits.
  

After you create an online account, you will receive an e-mail from us that includes your user ID and a link to our patient portal. You may log in at any time to activate your account and begin using our online services.

PDF Downloadable Web Forms

• Medical Records Release
• Cochlear Implant Appointment Agreement

Procedure / Surgery Instructions (downloads alphabetical order)

Adult Auditory Brainstem Response Instructions
ABR Sedated Instructions, Pediatric
ABR Unsedated Instructions, Pediatric
Atresia Repair Risk & Complications
Baha Consent Form
Baha Post Operative Care
Balance Canal Occlusion Surgery Risk and Complications
Balance Training Exercises
Cochlear Implant Expectations Pediatric
Cochlear Implant Expectations Adult
Cochlear Implant Risk & Complications
Cochlear Implant Hook-Up Appointment Form
Cochlear Implant Post-Op Instructions
Cerumen Impaction Instructions
Endolymphatic Sac Surgery Risk and Complications
Facial Nerve Decompression or Repair
Gentamicin Inner Ear Perfusion - Risk and Complications
Infratemporal Fossa Surgery Risk and Complications
Labyrinthectomy and Endolymphatic Sac Surgery Instructions After Surgery
Labyrinthectomy Risks and Complications
Myringotomy and Tympanostomy Ear Tube Placement Instructions Following Surgery
Myringotomy Risks & Complications of Surgery
Patulous Eustachian Tube Risks and Complications
Perfusion of the Inner Ear
Perilymphatic Fistula Risk and Complications
Sedated Discharge Instructions
Stapedectomy Risks and Complications
Stapedectomy Post Operative Instructions
Tympanoplasty/Mastoidectomy Instructions After Surgery
Tympanoplasty/Mastoidectomy Risk and Complications
Vestibular Evoked Myogenic Potentials (VEMP)
Vestibular Neurectomy Risk & Complications
VNG Instructions