The following is our new patient packet including all registration forms. It is form-fillable. Please click the .pdf link to download it.
Documents
Registration documents
Information for Prospective Patients - Single Form
The following is the Information for prospective patients. Please click the .pdf link to launch the form.
Driving Map
We are located in Portland, Oregon.
Click here for the google map, or print out our driving map below.
Patient Registration - Single Form
The following is our patient registration form. It is Form-fillable. Please click the .pdf link to launch the form.
Financial Policy - Single Form
The following is our Financial Policy. It is Form-fillable. Please click the .pdf link to launch the form.
Referring Physician Form - Single Form
The following is the referring physician form. It is Form-fillable. Please click the .pdf link to launch the form.
Voice History - Single Form
The following is our voice hostory form. It is Form-fillable. Please click the .pdf link to launch the form.
Area Information & Map
The following is the area information map. It contains information about area lodging, pharmacies, markets, and financial institutions. You can also view all this information on the "Planning your visit" page. Please click the .pdf link to launch the form.
New Patient Packet for Feminization Laryngoplasty Patients - All Forms for New Patients
The following is our new patient packet including all registration forms for FemLar patients ONLY. It is form-fillable. Please click the .pdf link to download it.
Patient Registration for Feminization Laryngoplasty Patients - Single Form
The following is our patient registration form for FemLar patients ONLY. It is Form-fillable. Please click the .pdf link to launch the form.
Information for Prospective Feminization Laryngoplasty Patients - Single Form
The following is the Information for prospective Feminization Laryngoplasty patients. Please click the .pdf link to launch the form.
Travel information
Driving Map & Directions to our Office
We are located in Portland, Oregon. Click here for the google map, or print out our driving map below.
Area Information & Map
The following is the area information map. It contains information about area lodging, pharmacies, markets, and financial institutions. You can also view all this information on the Planning Your Visit page. Please click the .pdf link to launch the form.
Tips for Your Stay
If you are coming to our office from out-of-town for a surgical procedure, please review this brief information sheet.
Consent documents
Medialization Laryngoscopy Consent
This consent form is for Medialization Laryngoscopy surgeries.
Microlaryngoscopy Consent
This consent form is for Microlaryngoscopy surgeries.
Feminization Laryngoplasty & Thyrohyoid Elevation Consent
This consent form is for Feminization Laryngoplasty surgeries.
Radiesse Injection Consent
This consent form is for Radiesse injections.
Denervation-Reinnervation Consent
This consent form is for Denervation-Reinnervation surgeries. This specifically applies to the recurrent laryngeal nerve. A portion or all of the recurrent laryngeal nerve is cut and in other nerve in the neck is donated. Typically the nerve called the ansa cervicalis going to the omoyhoid muscle is cut and donated. It iss sutured to the recurrent laryngeal nerve stump and will grow into the muscles of the larynx. When it goes in, it may provide some motion and some additional strength and bulk of the muscles within the larynx.
This procedure is also used for laryngeal spasms and laryngeal dystonia. The new nerve tends to eliminate the spasms.
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