The Ear Center of Greensboro, P.A. Ear Nose and Throat Physicians in Greensboro NC

1126 North Church Street  ~  Suite 201  ~  Greensboro NC 27401  ~  map
336-273-9932  Fax 336-273-9936
Mon-Fri 9:00 am - 5:00 pm by appointment only
  • Online Forms
    • List of Forms
      • Registration Form [PDF]
      • History Form: Adults [PDF]
      • History Form: Child < 12 [PDF]
      • Auditory Processing
      • Envoy Esteem Medical Hx
    • Registration Form [PDF]
    • History Form: Adults [PDF]
    • History Form: Child < 12 [PDF]
    • Auditory Processing Form
    • Office Info & Policies
  • Office
    • Map & Directions
      • Hotels & Restaurants
      • Greensboro Information
    • Office Policies
      • Participating Insurance
    • Registration Form [PDF]
    • History Form: Adults [PDF]
    • History Form: Child < 12 [PDF]
    • Surgery Instructions
      • Preoperative Instructions
        • Aspirin Management
        • Adenoidectomy
        • Ear Tubes
        • Medications
        • Tonsillectomy & Adenoidectomy
      • Postoperative Instructions
        • Adenoidectomy
        • Cochlear Implants
        • Eardrum Repair
        • Ear Tubes
          • Ear Tubes
          • Swimming
        • Envoy Esteem Implants
          • Initial Implant
          • Battery Replacements
        • Laryngoscopy
        • Mastoid Surgery
        • Nasal Surgery
        • Stapedectomy
        • Tonsillectomy & Adenoidectomy
    • Our Office
      • Office Info & Policies
      • Our Staff
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      • Privacy Policy
    • Emergencies
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      • Contact Us
    • Disclaimer
  • For Physicians
    • For Physicians
    • New Patients
    • What We Treat
    • Our Physicians
      • Eric M. Kraus, M.D., M.S.
        • Dr. Kraus's C.V.
        • Medical Publications
      • Su Wooi Teoh, M.D., M.S.
        • Dr. Teoh's C.V.
        • Medical Publications
    • Sub-Specialties
    • Audiology Services
    • Sleeping Baby Hearing Screen
      • Sleeping Baby Hearing Screen
      • Test Instructions
        • For Parents
        • For Physicians
        • Sleeping Baby Screen Video
      • Sleeping Baby Screen Video
      • Dr. William F. House
      • Our Baby Is Hearing Impaired
    • Research
    • Teaching Activities
      • AAO-HNS Courses
        • Lost Art of Medicine
      • Oral Presentations
      • University Affiliations
    • Kraus Microcut™ Forceps
      • Kraus Microcut™ Forceps
      • Hearing Results
    • Kraus K-Helix Prostheses
      • K-Helix Prostheses
      • Hearing Results
      • Video & Surgical Technique
    • Temporal Bone Lab & Training Center
      • TB Course Agenda
      • Faculty
      • TB Instrument List
    • Envoy ESTEEM Clinical Trial
      • ESTEEM Trial Description
      • Appointments
      • Medical History Form
      • Participation Criteria
        • Screening & Baseline Informed Consent
        • Clinical Trial Informed Consent
    • OR Microscope Photography
  • For Patients
    • What's New
    • Our Physicians
      • Eric M. Kraus, M.D., M.S.
        • Dr. Kraus's C.V.
        • Medical Publications
      • Su Wooi Teoh, M.D., M.S.
        • Dr. Teoh's C.V.
        • Medical Publications
    • Our Staff
    • What We Treat
    • Surgery Instructions
      • Preoperative Instructions
        • Aspirin Management
        • Adenoidectomy
        • Ear Tubes
        • Medications
        • Tonsillectomy & Adenoidectomy
      • Postoperative Instructions
        • Adenoidectomy
        • Cochlear Implants
        • Eardrum Repair
        • Ear Tubes
          • Ear Tubes
          • Swimming
        • Envoy ESTEEM Implants
          • Initial ESTEEM Implant
          • Battery Replacement
        • Laryngoscopy
        • Mastoid Surgery
        • Maxum Hearing Implant
        • Nasal & Sinus Surgery
        • Stapedectomy
        • Tonsillectomy & Adenoidectomy
    • Emergencies
    • Medical Ed Topics
      • Acoustic Neuromas
      • Benign Intracranial Hypertension
      • Connexin 26
      • Down Syndrome
        • Medical-Surgical Guidelines
        • DS References
      • Ear Tubes
      • Meniere's Disease
      • Migraine Disorders
        • Migraine Disorders
        • Migraine Vertigo
        • Headache I Diet
      • MRSA Infection
      • Noise Exposure
        • The Problem
        • Earphone Protection
      • Otosclerosis
        • Stapedectomy
      • Semi-Circular Canal Dehiscence
    • Sleeping Baby Hearing Screen
      • Sleeping Baby Hearing Screen
      • Test Instructions
        • For Parents
        • For Physicians
        • Sleeping Baby Screen Video
      • Sleeping Baby Screen Video
      • Dr. William F. House
      • Our Baby Is Hearing Impaired
    • Patient Info & News
    • Links
    • Emergencies
    • Contact Us
    • Disclaimer
    • Privacy Policy
  • Audiology
    • Audiology Department
    • Hearing Aids
    • Hearing Testing
    • Electronystagmography
      • About the ENG Test
      • ENG Instructions
    • Aud Brainstem Response
      • About the ABR
      • Adult ABR
      • Pediatric ABR
        • About the Pediatric ABR
        • Without Sedation
        • With Sedation
    • Auditory Processing
      • About Auditory Processing
      • AP History Form
      • Edulink FM Device
    • Sleeping Baby Hearing Screen
      • Sleeping Baby Hearing Screen
      • Test Instructions
        • For Parents
        • For Physicians
        • Sleeping Baby Screen Video
      • Sleeping Baby Screen Video
      • Dr. William F. House
      • Our Baby Is Hearing Impaired
    • Speech Pathologists
    • Tinnitus Therapy
      • About Tinnitus
      • UNCG Tinnitus Clinic
      • Neuromonics & Brain Adaptation
  • Hearing Aids
    • Hearing Aids
    • Phonak Hearing Aids
      • Audeo Yes
      • Nios
      • Exelia Art
      • Versata
      • Micro BTE
      • Certena
      • Naida BTE
      • Naida Junior
      • Audeo MINI
      • Audeo SMART
    • Widex Hearing Aids
      • Mind440
      • Inteo
      • Inteo & Flash m-Series
      • Mind330
    • Oticon Hearing Aids
    • Hearing Aid Service
    • Battery Special
    • DEMO Days
    • Testimonials
  • Hearing Implants
    • Hearing Implants
    • BAHA Device
    • Cochlear Implants
    • Envoy ESTEEM Device
      • FDA Advisory Panel Vote
      • Envoy ESTEEM Clinical Trial
      • ESTEEM Implant Animation
      • Appointments
      • Medical History Form
      • Participation Criteria
        • Screening & Baseline Informed Consent
        • Clinical Trial Informed Consent
    • Kraus K-Helix Prostheses
      • K-Helix Prostheses
      • Hearing Results
      • Video & Surgical Technique
  • Emergencies
  • Home
 

Participation Criteria for Envoy Esteem™ Pivotal Trial 0204

Medical History Forms

Click here for the Envoy Esteem Trial Participant Medical History Questionnaire (PDF format)

Click here for the Envoy Esteem Trial Participant Medical History Questionnaire (Word format)

Screening & Baseline Informed Consent

Click here to view or download the consent form

Clinical Trial Informed Consent

Click here to view or download the consent form

 

 

 

 

 

 

 

 

 

 

 

For Physicians Home

New Patients

What We Treat

Our Physicians

Sub-Specialties

Audiology Services

Research

Teaching Activities

Kraus K-Helix Prostheses

Kraus Microcut™ Forceps

Temporal Bone Lab/Training

Envoy ESTEEM Clinical Trial

OR Microscope Photography

Ear Center Home

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1126 North Church Street, Suite 201, Greensboro, NC 27401  ~  336-273-9932  Fax 336-273-9936  ~  Directions  ~  Privacy Policy
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