Physicians

• Hance C. Phillips, MD

• Ronald A. Burk, MD

• David M. Whitley, MD

• Thomas S. Holt, MD

Audiologists

• Mary Kyle, M.A., CCC-A

• Lynnette Hagerty, M.A., CCC-A
Patient
Services

• Ear, Nose and Throat Surgery

• Endoscopic Sinus Surgery

• Head and Neck Surgery

• Facial Plastic Surgery

• Audiology

• Hearing Aids

• Allergy Testing and Treatment

• Snoring/Sleep Apnea Treatment

• Computerized Tomography

• Videostroboscopy

• Laryngeal Sensitivity Testing
Practice

• Appointments

• Medical Services

• Office Locations

• Hospital Affiliations

• Out Patient Surgery Centers

• General Office Policies

• Accepted Insurance Plans

• Allergy Department

• Surgery Department

• Cosmetic Surgery
Patient
Education

• Patient Surveys

• Disease Surveys

• Pre-Operative Instructions

• Post-Operative Instructions

• Consultations

Listen to information about
Brevard Ear, Nose and Throat Center.
Patient Information:
New Patient:
Contact our office to schedule an initial consult. Please complete health history form before appointment.
Online and PDF Forms
-Both Forms Required-

COMPLETE THESE FORMS 24 HOURS BEFORE APPOINTMENT, IF LESS THAN 24 HOURS USE THE PDF FORM.

Review of Systems
Online Form

Patient History
Online Form
Review of Systems PDF

Patient History PDF

Print and FAX to
321-639-7222.
Patient Records Release Form

Print the above form fillout, sign and fax, email or mail to us.
OR
Fillout as PDF form and save to your machine, print, sign and fax, email or mail to us.
Existing Patient:
Contact the office if there are any changes that need to be made in your personal history information: Ex: Address, Phone or Insurance changes.
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1099 Florida Avenue
Rockledge, FL 32955

Phone: 321-632-6900