Forms and Links

Pediatric Otolaryngology Associates, LLC Daniel L Wohl, MD

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To DOWNLOAD and PRINT our Pediatric ENT Medical History Forms
prior to your child's appointment,
you will need to create your child's Patient Portal Account
on the North Florida Surgeons (NFS) website.
FIRST
Click on one of the appointment type numbered links added below,
which will take you to the NFS Homepage.
(IGNORE THE FORMS LINK ON THE NFS HOMEPAGE)
THEN
IN THE UPPER RIGHT HAND CORNER OF THE NFS HOMEPAGE,
1. Click on the Patient Login tab.
2. Follow the instructions to establish an account.
(PLEASE DO NOT FOLLOW THE NFS PROMPTS TO COMPLETE YOUR CHILD'S MEDICAL HISTORY ONLINE AT THIS TIME.)
3. On left side of the Portal homepage, click on "My Health".
4. Under "My Health" scroll down to "Medical Forms" and click.
5. Select the Pediatric ENT form that best applies to your child's Pediatric ENT or Audiology appointment.
6. Download the PDF form and complete it prior to your visit.
(If you are unable to complete this process,
please arrive 10-15 minutes early for pre-registration.)

North Florida Surgeons Homepage Link to the Patient Portal

Forms for New Patients
1. New Patient ENT
Medical History Form
(Please enter all demographic and medical information
for your child(ren) on the NFS Patient Portal
prior to coming to the office.)

1. click here to access the NFS Homepage

OR 2. New Patient - HEARING TESTS ONLY
Audiological History Form
(Please enter all demographic and medical information
for your child(ren) on the NFS Patient Portal
prior to coming to the office.)

2. click here to access the NFS Homepage

3. Notice of Privacy Policies for
North Florida Surgeons, PA
and Pediatric Otolaryngology Associates, LLC

3. click here to access the NFS Homepage

4. Financial Statement for
North Florida Surgeons, PA
and Pediatric Otolaryngology Associates, LLC

4. click here to access the NFS Homepage

Other Patient Forms
5. Established Patient
Medical History Form
(Please indicate whether or not you notice changes
in your child(ren) since your last visit
on the NFS Patient Portal before coming to the office)

5. click here to access the NFS Homepage

6. Auditory Processing Disorder (APD)
Medical History Questionnaire
(In addition, please complete either the New Patient ENT or
Established Patient Medical History form before your
APD evaluation appointment.)

6. click here to access the NFS Homepage

7. Permission Form for a Person
Other than the Parent/Legal Guardian
to Bring a Child to Dr. Wohl's Office

7. click here to download the permission form

Click Below for a Map and
Directions to our Office
Suggested Educational Pediatric Otolaryngology Links

Kids E.N.T. Health

Asthma and Allergy Foundation of America

Pediatric Audiology Information

Information about Auditory Processing Disorder

Miscellaneous Links

Florida Statue Section 119.501(5) Regarding Social Security Requests

Children and the Use of Complementary Health Approaches