About Your Visit
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| Pomco | Aetna |
| Empire blue Cross Blue Shield "Blue Choice" |
Loomis |
| Capital District Physician's Health Plan "CDPHP" | Medicare |
| New York State Empire Plan |
MVP |
| Local1199 National Benefit Plan | Wellcare |
If we do not currently participate with your insurance policy, please call our billing office; 845-471-4086. Many insurance plans allow for out of network benefits. In addition, our billing office can often work out payment plans for those not in affiliated plans.

Patient Office Forms
New Patient Information In order to allow our patients to spend less time in our waiting room filling out forms, we have included all the forms you will need to fill out right here on our web site. It provides important information about our office policies and appointment procedures. In addition, we encourage you to print out the each of the forms below, fill them out in the comfort of your own home or office and then simply bring them with you to your visit. |
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Complete Registration Packet
Medical History Form Only
ENT Review of Systems Form
Privacy and The Health Insurance Portability and Accountability Act (HIPAA)
The goal of Hudson Valley Otolaryngology, P.C. is to be HIPAA compliant in all aspects of the practice. For your information, below is our Notice of Privacy Practices along with a summary of this notice. Please take a few moments to review this notice and if you have any questions regarding the notice, please contact our Practice Administrator.
Notice of Privacy Practices
Summary of Our Notice of Privacy Practices
Acknowledgement of Receipt of Notice of Privacy Practices (HIPPA)
Thank you,
Hudson Valley Otolaryngology, P.C.
Forms Require Free Adobe Reader Software - download here if needed

Patient Information Sheets
Download PDF on Systemic Oral Steroids
Download PDF Nasal Steroid Sprays
Download PDF on Eustachian Tube Dysfunction
Download PDF document on Cerumen Impaction
Download PDF on Risks & Complications related to Endoscopic Sinus Surgery
Download Post Operative Instructions on Endoscopic Sinus Surgery, Nasal Septum & Turbinates
Download PDF on Tinnitus

Pre & Post Operative Instructions
Click on the procedure/surgery that you are having for further information:

