Dear Referring Physician,
- If you are referring a patient to us, please provide:
- Your contact information
- A referral for the visit
- All visits require a referral for nasal endoscopy (CPT code 31231/31237)
- A copy of sinonasal XRAYS / CT scans (both films and reports)
- Copies of records related to the patient’s sinuses/nose/allergies/lungs.
Thank you for your referral!
Please prepare your patient for their visit by bringing:
- A picture I.D. and your health insurance card/information.
- The co-pay required by your insurance carrier.
- Please check with your insurance carrier to determine if a referral is required for a clinic visit with us.
- If you have HMO insurance, you must have a referral for this visit.
- If you have HMO insurance, you must also obtain a referral for nasal endoscopy (CPT code 31231/31237)
- Your referring physician’s or primary care physician’s name and contact information.
- A copy of your XRAYS / CT scans (both films and reports)
- Copies of records from doctors related to your sinuses/nose/allergies/lungs.
- A list of all medications you are taking
- Completed forms
Your patient may also want to have:
- A list of your questions /concerns
- A friend or family member to take notes/help with questions
- If you are 30 minutes late for your appointment, it will be rescheduled.
- If you are unable to keep this appointment, please provide 24 hours notice.
Office Forms (Downloadable PDF's)
Billing & Insurance
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About The Department
Illinois Eye and Ear Infirmary Dr. Stephanie Joe
In 2008, The Illinois Eye and Ear Infirmary celebrated its 150th year of excellence in patient care, education, and research. It’s history is rich with leading advances in the fields of rhinology, head and neck surgery, laryngology, otology, and facial plastic surgery.
Links to other faculty member websites: