New patients will need to have these forms completed before initial office visit.
Fill out this form if your medical records need to be transferred to Dr. Leiders office prior to visit.
Dr. Leiders office may require you to document and keep records of your personal medication.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA)
- After Nose Surgery (PDF)
- Adenoidectomy before and after (PDF)
- Tonsillectomy before and After (PDF)
- Tympanostomy (PDF)
- Uvulopalatopharyngoplasty (PDF)