Emeryville ENT
Emeryville ENT
At Emeryville ENT, we offer expert medical care in treating and diagnosing your ear, nose, throat, head, neck, and sinus issues. Our 30-year history serving patients in the East Bay combined with our partnership with Stanford Health Care, allows us to provide you immediate access to Stanford specialists and technology, while continuing to provide care tailored to you.
5800 Hollis St. Pavilion A 4th Flr
Emeryville,
CA
94608
Phone: 510-806-2100
Our Doctors
Our Care Team
For Patients
Patient Forms
Please be sure to download the appropriate forms prior to visiting a UHA medical group. You may download the following PDF files and open them using the free online program, Adobe Acrobat Reader. Download the latest version of Acrobat Reader.
- HIPAA Acknowledgement Form (PDF)(Please read before your first appointment) - Español
- Notice of Privacy Practice (PDF)(Please read before your first appointment) - Español
- Terms & Conditions of Service (PDF)(Please read before your first appointment) - Español - Chinese
- Authorization for Use or Disclosure of Protected Health Information (PDF) - Español
- Explanation About Billing Charges for Your Preventive Visit (PDF) - Español
- Annual Medicare Wellness Visit Information (PDF) - Español
- Medicare Health Risk Assessment (PDF)
- Behavioral Standards
- Financial Assistance Application (PDF)(Complete if needed) - Español
- Notice of Nondiscrimination(PDF)
Call us to make an appointment
New to Summit ENT? Schedule your appointment online.
Online AppointmentReturning Patient
To request an appointment with an Otolaryngologist, call 510-806-2100.
