New Patient Forms
Singers

If you are a new patient who is a singer being seen for voice complaints,

please download, complete, and bring this form with you to your visit with

Dr. Heman-Ackah:
Our office staff is available to help you with all of your questions
Including:

Prescription refills
Procedure authorization
Prescription authorization
Scheduling appointments
Surgical scheduling
Pre-op testing
Voice therapy
Singing therapy
Feel free to call us anytime.....

  (484) 270-8095 

   Looking forward to talking with you soon!
Voice Problems/Hoarseness

If you are a new patient and are having problems with your voice and you

are not a singer, please download, complete, and bring this form with you

to your visit with Dr. Heman-Ackah:
Ear, Nose, Throat, or Head and Neck Problems

If you are a new patient who is seeing Dr. Heman-Ackah for an ear, nose,

throat, head, or neck problem other than your voice, please download,

complete, and bring this form with you to your visit:
Post-operative Instructions
If you had or are planning to have surgery with Dr. Heman-Ackah, the following forms are the instructions for how to take care of your wound after your surgery is complete.
Questions about Surgery?

   Call the office at

(484)270-8095
Removal of vocal fold mass
(i.e. polyp, nodule, cyst, scar, papilloma, cancer)
Thyroplasty (implant to move vocal fold over)
Vocal fold injection
(fat, collagen, voice gel, Radiesse)
Arytenoidectomy or surgery at front of vocal folds
Thyroidectomy
Tonsillectomy
Nose or Sinus Surgery
Reflux Instructions
If you've been diagnosed with reflux laryngitis or laryngopharyngeal reflux disease, download the form below for instructions on how to minimize reflux.
Philadelphia Voice Center
Professional Voice Care, Otolaryngology-Head and Neck Surgery
Philadelphia Voice Center is a registered trademark of Yolanda D. Heman-Ackah, MD, PC
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