FORMS
Here are our most commonly utilized forms.
They can be completed on smart phones, tablets, or computers.
Please fill this out before you call to schedule your first appointment with us
Please fill this out before you call to schedule your first appointment with us
This is the form to complete before scheduling COVID testing
This should be completed before scheduling ear piercing with us
FORMULARIOS
Aquí están nuestras formas más comúnmente utilizadas.
Se pueden completar en teléfonos inteligentes, tabletas o computadoras.
Por favor, llene esto antes de llamar para programar su primera cita con nosotros.
Por favor, llene esto antes de llamar para programar su primera cita con nosotros.
Este es el formulario que debe completar antes de programar la cita para la prueba del COVID
Esta forma se debe de completar antes de ser su cita de perforacion de orejas.
INSURANCE INFORMATION
We want to make it as easy as possible to get the care you need
Riviera ENT is out of network with some plans. However, consultation may be more affordable than you might think
TELEMEDICINE
Riviera ENT is dedicated to providing ENT care in person and via telehealth (video).
TIPS FOR A SUCCESSFUL TELEMEDICINE VISIT
Check your internet connection
Make sure your audio and video are working and enabled
Please check in at least 10 minutes before your visit using your cell phone, tablet, laptop or desktop
Find a quiet, private location if possible
Check your lighting
Write down problems and questions ahead of time
Dress appropriately for the visit
Consider using headphones
Be an active participant in the exam
Have a trusted assistant if necessary
October 2020 Update: We have switched to a new medical record system, Elation, to better serve you. We anticipate access to a patient passport in the near future. We also changed our billing company to provide you better service.
To schedule an appointment:
please call 805-327-6673, or
email us at info@rivieraent.com
WHAT TO BRING TO YOUR APPOINTMENT
For new patients, completing our online portal is the best way to prepare for your visit. Your health information is secure and protected through the portal and will save you time on your first visit.
To help us give you the best possible appointment experience, please bring with you:
A photo ID and health insurance card
If you have not completed the portal:
A list of all your medications and allergies
Your medical history
Your preferred pharmacy
PLEASE ARRIVE 15-20 MINUTES EARLY TO COMPLETE THE PAPERWORK
Pertinent Outside Medical Records
Please let us know about prior pertinent testing (labs, audiograms, balance tests, imaging studies, biopsies) or prior specialist doctor visits ahead of your visit
Copies of outside imaging studies, including the actual images themselves if possible
If your child will be coming with a non-parent or non-legal guardian, you will need to have completed the reauthorization to treat minors consent form before the visit
We thank you for your diligence and look forward to seeing you at your appointment!
EAR PIERCING NOW AVAILABLE!
We offer ear piercing by appointment only. Our well-trained medical assistants perform piercings at Riviera ENT. Babies must have had their 2-month vaccinations prior to scheduling.
Complete this form then call our office to schedule
There are 2 methods you can choose between: a non-gun medical piercing device or a piercing needle- akin to what a tattoo or piercing study offers.
Earring choices vary depending on which method you choose.
Piercing device: There are infant 24-K gold studs, or stainless steel with cubic zirconia or 24-K gold with cubic zirconia earring options.
Piercing needle: There are titanium (with gold, silver or rose gold tints and cubic zirconia) and medical-grade plastic options.
The charge is $100 and includes the earrings, the piercing, and an after-piercing saline wash mist can. Fees are nonrefundable.
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PATIENT CODE OF CONDUCT
Riviera ENT Patient and Visitor Code of Conduct
Riviera ENT is committed to providing high-quality care to our patients and communities in a safe and respectful environment that supports health and healing. To ensure our clinic is safe, caring, and inclusive, we ask that patients and visitors follow the example of Riviera ENT by adhering to our Patient and Visitor Code of Conduct, which includes the following:
Everyone will be treated with kindness, dignity, and respect. Offensive comments about race, religion, gender, sexual orientation, or personal traits are not acceptable, and neither is the refusal to see a clinician based on these traits.
All patients and visitors will use respectful, appropriate language and behavior. Physical or verbal threats or assaults, suggestive or explicit words, phrases, gestures, or actions will not be tolerated.
All patients and visitors will respect patient privacy and avoid disrupting other patients’ care or experiences.
All patients and visitors must obtain the consent of everyone involved for any photographing or video/audio recording within Riviera ENT or other treatment sites
If these guidelines are not followed:
Patients may be asked to leave and make other plans for their non-emergent immediate care.
Patients will be discharged from the practice for disrespectful or inappropriate behavior.
In cases of non-compliance, patients will have an opportunity to explain their perspective, which will be considered prior to any decisions regarding future care at Riviera ENT.
Visitors may be asked to leave and could be restricted from future visitation.
Every day, our physicians and staff are committed to providing the highest levels of care to our patients. Please show them the respect they deserve and that you expect as a patient or visitor.
Thank you for choosing Riviera ENT and joining us in our commitment to ensuring a safe, caring and inclusive environment for us all.