Pre-Qualification Form

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Please contact your local ENT office, who should be able to treat the patient.

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1. Other than ear infections, is your child healthy?

Yes No

2. Does your child have any of the following?

3 or more episodes ear infections treated with antibiotics in past 6 months.
4 or more episodes ear infections treated with antibiotics in past 12 months.
Persistent fluid in the middle of either ear for more than three months?

Yes No

3. Has a pediatrician recommended Ear Tubes?

Yes No

4. Has your child ever had ear tubes before?

Yes No

Contact Information

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Your child qualifies

Thank you for your interest in TubesToday. With six Richmond-based, board-certified Ear, Nose & Throat doctors as a part of our network, we are certain that the pain your child is suffering from will soon be remedied.

With current wait times for ear tube surgery being four to six weeks, TubesToday was established to help parents get the care they need for their child quickly. Helping you get your child scheduled for his or her surgery within 48 hours is what we’re here to do.

There are two options for how to proceed:

Call us for more information and to get your child qualified: 804-251-8044.
Complete the remaining form on our website, which will simply schedule a visit with one of the local, board-certified ENTs you choose, at a time that is convenient to your schedule. To access the form, click here: Qualification Form

The online form is confidential and should take less than 5 minutes to complete. This process will ask more in-depth questions such as your child’s insurance and the best day and time to schedule an appointment with a local ENT. Please note, there will also be a $45 reservation fee that will be allocated to the overall procedure. If you have questions about this fee, don’t hesitate to call me.

After the form is complete, TubesToday will send you an appointment confirmation email as well as a follow-up with your chosen ENT doctor.

Again, if you have any questions or concerns please call our office at 804-251-8044. We are open from 9 am to 4 pm Monday thru Friday.

Thank you for using TubesToday.

Kat Eddowes