Toggle Navigation
75 Thomas Johnson Drive • Suite B Frederick, MD 21702 | Call 301.695.EARS | Fax: 301-695-7403

New Patients

At  Mid Maryland ENT we value your time and your privacy. You can download, print and print the following forms with you.

At Mid-Maryland ENT, we value our patients’ time and privacy. That’s why we make our New Patient Registration Form available on this website for you to print and complete before your visit.

Mid Maryland ENT follows Federal HIPAA requirements for maintaining patient privacy and health care portability.

Please bring any relevant X-ray films to your visit. A report is NOT sufficient.

* We are currently converting to a new EMR system and it will be activated soon. Please check back soon.

Patient Portal