Call Us Today! 703-573-3687
Laurence O’Halloran MD
Timothy Egan MD
Sarah Blank MD

ENT Health Assessment Survey

27 Feb 2016 

-Under construction-

Initial Consultation

16 Jan 2015 
Fairfax ENT Review

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your referral slip and any X-rays, CT scans, MRI films, Hearing tests or Sleep studies (if applicable)
  • A list of your current medical prescriptions
  • If you have medical insurance, bring the necessary completed forms and your insurance card. This will save time and allow us to help you process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

X-Ray/CT/MRI

If your physician has ordered a previous diagnostic study please bring a copy of the images on a CD with you to your appointment. If you do not have a copy of the images on CD contact the imaging center where the scans were done and they can burn you a copy.

Office Hours

16 Jan 2015 

Office Hours

Early AM and Evening Appointments now available.
Same day appointments available.
Office visits by appointment only.

Physicians Allergy Shots ** Audiologist
Monday 9:00am – 4:00pm 9:00am – 3:50pm 9:00am – 4:30pm
Tuesday 8:00am – 4:00pm 8:00am – 3:50pm 8:00am – 4:30pm
Wednesday 7:00am – 7:00pm 7:00am – 6:00pm 8:00am – 4:30pm
Thursday 9:00am – 7:00pm 9:00am – 6:00pm 8:00am – 5:00pm
Friday 8:00am – 3:30pm 8:00am – 3:30pm 8:00am – 4:30pm
Saturday * 8:00am – 12:00pm
Sunday Closed

* Saturday Hours vary from month to month.
** If you are coming for a vial test, please arrive 30 minutes before closing time.

Call 703-534-3314 to schedule your appointment or use the form below.








    MorningAfternoon




    Financial Policy

    16 Jan 2015 
    Fairfax ENT Financial Policy
    APPOINTMENT CANCELLATION

    If office appointments cannot be kept, for any reason, telephone cancellation should be made as soon as possible.

    INSURANCE CLAIMS

    We accept most insurances and will be happy to submit insurance forms to your insurance company. We will collect your copay at the time of your visit. We accept personal checks, cash, Visa and MasterCard. If you do not have insurance please call the office to discuss rates. Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. If you have questions regarding your account, please feel free to call. Many times, a simple telephone call will clear up any misunderstandings.

    Office Manager: Britt Kavoukas 703.573.3687
    Billing Manager: Cheryl Garrison 540.937.2588

    WAITING

    It is the nature of our specialty that emergencies occur and require prompt care. We know your time is valuable and we will make every effort to see you on time. Please remember that if you ever have an emergency we will be happy to see you on the same day.

    Insurance Information

    16 Jan 2015 
    Fairfax ENT Insurance

    AT Fairfax ENT & Facial Plastic Surgery we make every effort to provide you with the finest care and the most convenient financial option. We work closely with your insurance carrier to maximize your reimbursement for covered benefits. We participate with most commercial insurance plans and Medicare. If you do not see you insurance company on the list below please call 703-534-3314 and our office staff will be happy to help you.

    Insurance Plans

    Aetna US Healthcare

    Anthem Blue Cross/ Blue Shield

    Blue Cross Blue Shield Federal Employees

    CareFirst Blue Cross/ Blue Shield

    Cigna Healthcare of Mid-Atlantic

    MAMSI

    Medicare

    NCPPO

    One Health

    Private Healthcare Systems- PHCS

    United Healthcare First Health

    Hospital Affiliations

    16 Jan 2015 
    Fairfax ENT Hospital Affiliation

    Our doctors have surgical and admitting privileges at the following hospitals:

    INOVA Fairfax Hospital
    3300 Gallows Rd.
    Falls Church, VA 22042
    703. 776.4001

    Georgetown University Hospital
    3800 Reservoir Road NW
    Washington DC 20007
    202.444.2000

    INOVA Fair Oaks Hospital
    3650 Joseph Siewick Dr.
    Fairfax, VA 22031
    703. 391.3600

    Our doctors have surgical privileges at the following outpatient facilities:

    Fairfax Surgical Center
    10730 Main St.
    Fairfax, VA 22031
    703. 691.0670

    Ambulatory Surgical Center at Fairfax Hospital
    3300 Gallows Rd.
    Falls Church, VA 22042-3300
    703.691.0670

    Forms

    16 Jan 2015 
    Fairfax ENT Financial Policy

    New Patient Registration

    Please complete the following forms and bring them to your first visit

    NOTE: The form e-mail option works reliably only if you use Adobe Acrobat Reader (download link below). After you fill out the form, please save the file. If the email function does not work then save the completed file and email to info@fairfaxent.com. You may also choose to print the form out and hand carry to your office visit.

    If your visit concerns problems with your nose or sinuses such as chronic sinusitis, nasal obstruction, deviated septum etc, then please fill-out the SNOT-22 form, print it and bring to your visit. 

    Print and sign this form and bring with you to your visit.


    Additional Forms

     

     

    Supplies

    16 Jan 2015 

    Throat Reflux

    Bed Blocks

    130760F5-BB1F-4049-B218-8AB5BBF61B69

    Bed Wedges