Forms & Surgical Instructions

Vernick & Gopal Ear, Nose & Throat Specialists Registration Forms

• Dr. Vernick-New Patient Registration
• Dr. Gopal New Patient Registration Form
• ENT Pediatric New Patient Registration
• Dizzy Evaluation with Dr. Vernick

Vernick & Gopal Hearing Center Registration Forms

• Dix Hallpike/ Epley Maneuver Instructions and Questionnaire

Medical Releases

• Authorization to release Medical Records from Vernick and Gopal, LLC
• Authorization for outside medical records to be sent to Vernick and Gopal, LLC

In Office Procedures

• Office Balloon Sinus Surgery
• Coblation Procedure

Preoperative Instructions

• Preoperative Medication Restrictions

Beth Israel Deaconess Medical Center:

• Preparing for Your Surgery

Children's Hospital:

Day Surgery:

• Pre-operative instructions and what to expect

Post-operative Instructions for Your Child:

• Adenoidectomy
• Ear Tube Placement
• Tonsillectomy

Postoperative Instructions

Ear Surgery

• Canalplasty
• Tympanoplasty/Ossiculoplasty/Middle Ear Surgery
• Stapedectomy
• Mastoidectomy/Tympanoplasty

Other

• Tonsillectomy/Adenoidectomy
• Nasal and Sinus Surgery