Michael E. Villano, MD
431 NE Revere Ave Suite 100
Bend, OR 97701
541/312-1145

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CLICK HERE to get your ENT patient registration forms.

This website uses information supplied from the AAO-HNS.

 

Patient Registration Forms
Dr. Michael Villano CASCADE ENT: Ear, Nose and Throat - Head and Neck Surgery

These forms are in Adobe (pdf) format and require Adobe reader. This is a free download from Adobe. If you need Adobe reader follow the Adobe link. Adobe.com

There are several pages to each packet. Please select the packet that best corresponds with your appointment type.

Fill Out Online:

How to use PDFescape to fill these forms out online:

You may proceed to the form unregistered. Select the text tool (upper left) to type and "Freehand" tool to create signatures anywhere on the document. Save your edited pdf to your PC using the green "download" icon. Email as an attachment to info@cascadeent.com, or fax to (541) 330-2499

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Please be sure to complete your registration forms prior to your office visit.

 

Michael Villano, MD Specializing in Ear, Nose and Throat - Head and Neck Surgery
431 NE Revere Ave Suite 100, Bend, Oregon 97701 541/312-1145
& 645 NW 4th St. Redmond, OR 97756
Michael E. Villano, MD, Ear Nose and Throat, Head and Neck Surgery in Central Oregon
©Copyright 2016 Michael E. Villano, MD, LLC

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