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4210 North Roxboro Rd., Suite 140  •  Durham, NC 27704  •  919-620-7800

The staff of Triangle ENT considers the patient’s personal health information and all information related to the care of any patient to be confidential and protected by law.

Click on the icons below to open a secure document for each form. Please fill out each form on-line and securely submit them to our office prior to your next appointment.

If you'd like a copy of the form, please print it prior to clicking the Submit button.

Patient Information
Patient Information
1 of 4
General Medical Info
General Medical Info
2 of 4
Systems Review
Systems Review
3 of 4
Request for Confidential Communication
Request for Confidential Communication
4 of 4
 


Notice of Privacy Practices