Accessibility Tools

Telemedicine Visits Available

Slider-1 Slider-2 Slider-3 Slider-4 Slider-5 Slider-6 Slider-7 Slider-8


Call Us Today

Patient Resources

Nasal and Sinus Problems

Nasal and Sinus Problems

Throat Problems

Throat Problems

Ear Problems

Ear Problems

Please download, print and fill out these forms, and bring them with you to your first appointment. For continuing patients, if your personal or insurance information changes, please fill out a new Patient Information form and bring to your next appointment.

get adobe readerClick on any icon above to download an Adobe Reader® document of that form. If you don't have Adobe Reader on your computer, click here for a free download.

New Patient Forms
New Patient Forms
Records Request
Records Request
Disclosure Authorization
Disclosure Authorization
SHENT PrivacyPractices
Notice of Privacy Practices

Policy for Self-Pay Patients

South Hills ENT Association accepts patients who are considered to be “Self-pay” with the understanding that the patient will be asked to pay all charges associated with their care.

Due to the varying nature of each visit, we cannot tell you in advance what the entire charge will be. Thus, we ask for a good faith effort to pay at the time of the visit.

You will be responsible for all charges billed to your account. New patients will be required to pay a $150 deposit upon check-in. Established patients will be required to pay a $100 deposit upon check-in. Any additional charges will be collected at the end of the visit.

If you are unable to pay the entire bill at your visit, you must make prior arrangements with our billing office, at (412) 831-7570 x224. They will utilize the following schedule for your balance due:

$100 or less Payment IN FULL within 30 days
$101-$600 6 months
$601-$1800 12 months
$1801 or more 18 months


If you do not pay your balance in full or make payment arrangements, your account will be referred to a Collection Agency after ample internal efforts are exhausted.

If you have any questions regarding this policy, please feel free to contact our Practice Administrator at (412) 831-7570 x325.

Please plan to arrive 15 minutes prior to your scheduled appointment time. You will need to bring your insurance card, your co-payment, and your primary care physician’s referral if you belong to an HMO or PPO plan that requires a referral for a specialist. Please note that you will be asked to pay your insurance co-payment at the time of your visit. For your convenience, South Hills ENT Association accepts cash, personal checks, and most major credit cards.

You will be asked to complete a Patient Information form, and a form for your Medical History.

In order to have the most complete and accurate information, bring a written list of any medications, including any over-the-counter medications and nutritional supplements you are currently taking. Also be prepared to list prior treatments and surgeries, even if they are not related to your current problem.  If you have had any testing pertinent to your problem, please obtain a copy of the results and bring them to our office. If you had an X-ray, MRI or CT scan, it would be beneficial to bring the disc with you.

If you need special assistance, please consider asking a friend or family member to accompany you. Let us know when you schedule your appointment if you have any special needs that we can assist with.

At Our Office

Be honest and complete when you are talking to your doctor. He needs to know as much information about your condition as possible in order to design the most effective treatment plan for you. Feel free to take notes about your treatment, and ask questions if there is anything you don’t understand. We have many patient education brochures and handouts for you to review and use at home.

Follow Up Care

To achieve the best results for your condition, it is important to follow your doctor’s instructions. Take your medications as prescribed, and for the amount of time your doctor has recommended.

If you have any concerns or questions, or if your condition changes, please call our office.