Contact

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

I would like to(Required)

Schedule a new patient appointment

Schedule a follow-up appointment

Reschedule an appointment

Discuss Insurance and Billing

Discuss my experience in your clinic (Please visit survey)

Please contact me by

Phone

Text

Your relationship with your doctor is one of the most important you have. While visiting our office there’s a lot of information to process, protocols and insurance to deal with. We genuinely care about your experience and appreciate feedback from you on how to improve your time with us. We will call you within the next business day (M-F) to discuss any issues. Thank you, from the doctors and our staff!

Preferred Provider

Sivi Baktha MD FACS

How did you find our practice?

Your WEBSITE online

Family, friend or patient

Referral from a doctor

Employer or insurance company

Google

Facebook

Other Social Media (Yelp, Twitter, etc.)

Internet doctor site (eg Healthgrades)

What words did you search to find us on the Internet?

Please enter the code to protect your privacy and security.

Please note that this is an online appointment request and a scheduler will call you within the next business day (M-F) to get the information required to confirm your appointment. We will do our best to meet your scheduling needs. If you experience any difficulty in using this form or do not receive a call from our office within 24 hours, please contact us.

Contact

Sivi Baktha MD

Pediatric Ear, Nose, Throat, and Sinus

Otolaryngology-Head & Neck Surgery, Sleep Medicine, Pediatric Otolaryngology

Dr Sivi Baktha Online Appointment Request