Want to Shorten Your Time in the Waiting Room?
Make your first visit with Dr. Tom Brandeisky go a little quicker! Before you schedule your next appointment, download the following forms and fill them out to the best of your ability. Bring these with you on your next visit and save valuable time!
- Acknowledgment of Receipt of Notice and Approval of Privacy Practices
- ENT & Facial Plastic Surgery Associates
- Notice of HIPPA Privacy Practices Updates
- Patient Medical History Patient Registration
- Permission to Recieve Prerecorded Messages and or Text Messages
If you have questions about any of the forms, please do not hesitate to contact our staff and we will be glad to help.
Accepted Insurance Carriers
- Beech Street
- Blue Cross Blue Shield
- Community Healthcare Network
- Devon Health Services Inc
- Great West
- Health Net
- Horizon Blue Cross Blue Shield
- International Union of Operating Engineers
- MediChoice Insurance
- Oxford Health Plans
- Railroad Medicare Beneficiaries