Skip to main content

Refer a Patient to Ear, Nose & Throat

New Patient Appointments (provider referral required)

Step 1
Complete Form
Step 2
Review and Schedule

Complete the New Patient Appointment Form.

For best results, please use Google Chrome.

The Children’s Mercy Contact Center will call the patient within 2 business days to schedule.

Scheduled and requested appointment status can be found on the Wednesday referral reports.


Follow-Up Appointments

Follow up appointments should be scheduled by the patient by calling the ENT Clinic at (816) 234-3040.


Specialty referral instructions:

Please review criteria in these forms before submitting a referral.

Recurrent Tonsillitis

Recurrent Otitis

Tonsil SDB

Conditions Treated

Acute and chronic ear infections, tongue tie, auricular hematoma, brachial cleft cyst, cholesteatoma, dizziness/vertigo, dysphagia/swallowing, ear trauma, ear tubes, epistaxis, facial cellulitis, facial palsy/paralysis, foreign body obstructions in ears or nose, hearing loss, hemangioma, hoarseness/dysphoria, impacted cerumen, laryngomalacia, lymphadenopathy/lymphedema, mastoiditis, nasal congestion, adenoids, nasal fracture, nasal polyps, head or neck masses, ear pain, preauricular abscess, recurrent croup, septal hematoma, drooling, sinusitis, sleep disordered breathing, ruptured eardrum, thyroglossal duct cyst, tonsil disorder, tonsil/pharyngeal abscess, torticollis, tracheostomy, vocal cord paralysis, VPI


This clinic requires that a physician's referral be submitted prior to scheduling an appointment.

For hearing loss, please be advised the patient may be referred to Hearing & Speech for an audiology evaluation.