See Dr. Goldberg’s profile on Healthgrades.


Location

723 Fitzwatertown Road Willow Grove, PA 19090

Call Us

(215) 659-8805

URGENT CARE ENT

Same day appointments
(215) 659-8805

Ear Nose Throat & Facial Plastic Surgery Specialists, PC

For appointments not kept or cancelled less than 24 hours peior to your appointment date & time, the full charge of the visit, diagnostic testing, procedure, and or surgical procedure, will be charged to you.

Insurance Information

If insurance is held by someone other than the patient, please fill out the information below:
I AUTHORIZE RELEASE OF ANY MEDICAL INFORMATION NECESSARY TO MANAGE MY CARE.
I UNDERSTAND AND AGREE THAT REGARDLESS OF MY INSURANCE STATUS, I AM ULTIMATELY RESPONSIBLE FOR THE BALANCE ON MY ACCOUNT FOR ANY PROFESSIONAL SERVICE RENDERED. I HAVE COMPLETED THE ABOVE QUESTIONS AND CERTIFY THIS INFORMATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I WILL NOTIFY YOU OF ANY CHANGES IN MY INSURANCE STATUS OR ANY OF THE ABOVE INFORMATION. I AUTHORIZE THE STAFF TO PERFORM ALL NECESSARY SERVICES NEEDED DURING THE DIAGNOSIS AND TREATMENT. I ALSO AUTHORIZE THE PROVIDER TO RELEASE ALL INFORMATION REQUIRED TO PROCESS INSURANCE CLAIMS.