Patient Resources
What should you bring to your appointment at Evergreen Sinus Center
We want to answer as many of your questions as possible at your visit
Please prepare for this by bringing:
- Health Insurance Card/Information
- A friend or family member to take notes/help with questions
- A list of all medications you are taking
- A list of your questions /concerns
- A copy of your XRAYS / CT scans (not the reports - please get the actual films)
- Copies of records from doctors related to your sinuses/nose/allergies/lungs.
- Completed FORMS below
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New Patient Office Forms
Adult & Pediatric Forms are proprietary & developed by Intelligent Medical Records.
Returning Patient Forms
Post Operative Instruction Forms
Forms Require Free Adobe Reader Software - download here if needed
INSURANCE AND INSURANCE COLLECTION
We are committed to your treatment being a successful one. Our Billing Administrator will work hard to ensure that your paperwork is filed accurately and promptly. It is your responsibility to be fully knowledgeable about your insurance coverage. Your insurance plan conditions, exclusions, co pays, and deductibles are usually negotiated for you by your employer or plan purchaser. This information can be found in your insurance benefits booklet, on your insurance web site, or by calling the number on your insurance card.
Download Financial Agreement
Financial Disclosure Statement
Industry Relationships
Dr. Kenneth Faw is intensely interested in being involved in research for the purpose of making the latest technology and treatments available to his patients. He also greatly enjoys teaching other physicians and surgeons to share his insights and experience.
Dr. Faw wishes to publicly disclose payments for speaking and consulting of $5,000 or more per year, and any equity, royalties, and fiduciary relationships in companies with which he collaborates. In publicly disclosing this information, Dr. Faw wishes to provide information as accurately as possible about his connections with industry and those of his immediate family.
As of 1/1/2009, Dr. Faw reports the financial relationships with the companies and facilities listed below. Patients or referring physicians should feel free to contact Dr. Faw about any of these relationships.
Hospital Affiliations
Evergreen Surgical Center LLC
Evergreen Surgical Center is dedicated to providing the highest quality care in a warm and supportive environment. Working together with expert surgeons, the Center is specially designed to provide you the finest in outpatient surgical care, followed by recuperation in the comfort of your own home. By avoiding unnecessary hospitalization, the Center also helps reduce the cost of medical care.
Evergreen Surgical Center offers eight fully-equipped operating suites plus one minor procedure room with the capability of performing several hundred types of procedures spanning many specialties.
Evergreen Surgical Center operates as a Limited Liability Corporation (LLC), and 
is jointly owned by Evergreen Healthcare and physician owners. The Center is fully accredited by Medicare and The Joint Commission. The Joint Commission is the nation’s predominant standards-setting and accrediting body in health care, focusing on improving the quality and safety of care provided by health care organizations. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting specific performance standards. To earn and maintain The Joint Commission’s Gold Seal of Approval™, an organization must undergo a rigorous on-site survey by a Joint Commission survey team at least every three years.
In addition the Center maintains a rigorous and thorough credentialing and quality peer-review process to assure the highest standards of practice from the physicians on staff.
ENT Glossary
Otology/Neurotology: diseases of the ear, including trauma (injury), cancer, and nerve pathway disorders, which affect hearing and balance.
Examples: ear infection; swimmer's ear; hearing loss; ear, face, or neck pain; dizziness, ringing in the ears (tinnitus).
Pediatric Otolaryngology: diseases in children with special ENT problems including birth defects in the head and neck and developmental delays.
Examples: ear infection (otitis media), tonsil and adenoid infection, airway problems, Down’s syndrome, asthma and allergy/sinus disease.
Head and Neck: cancerous and noncancerous tumors in the head and neck, including the thyroid and parathyroid.
Examples: lump in the neck or thyroid, cancer of the voice box.
Facial Plastic and Reconstructive Surgery: cosmetic, functional, and reconstructive surgical treatment of abnormalities of the face and neck.
Examples: deviated septum, rhinoplasty (nose), face lift, cleft palate, drooping eyelids, hair loss.
Rhinology: disorders of the nose and sinuses.
Examples: sinus disorder, nose bleed, stuffy nose, loss of smell.
Laryngology: disorders of the throat, including voice and swallowing problems.
Examples: sore throat, hoarseness, swallowing disorder, gastroesophageal reflux disease (GERD).
Allergy: treatment by medication, immunotherapy (allergy shots) and/or avoidance of pollen, dust, mold, food, and other sensitivities that affect the ear, nose, and throat.
Examples: hay fever, seasonal and perennial rhinitis, chronic sinusitis, laryngitis, sore throat, otitis media, dizziness.
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