Welcome to The Ear Clinic NYC
Founded by Michael Boyd — where your ear health and comfort come first.

Thank you for choosing The Ear Clinic NYC.

In the next section, you’ll find the required Patient Intake Form, which must be completed before receiving care. Please fill out the form in full and sign the consent section to confirm your understanding of the ear irrigation procedure, including the steps involved and any potential risks or side effects, and to grant permission for care. This process ensures that you fully understand the procedure, allows our nurse to review your medical history, and helps us provide safe, personalized treatment tailored to your needs.

Photo ID Required:

To ensure your safety and compliance with medical standards, a valid government-issued photo ID and signed consent form are required before any service can be performed. This allows us to provide safe, personalized care based on your medical history and ear health needs.

Booking Policy:

If you are booking your service online, please note that a small booking fee applies to secure your appointment. Walk-in appointments are welcome and do not require a booking fee, though availability may vary. We appreciate your trust in The Ear Clinic NYC and look forward to providing you with professional, high-quality care in a calm and respectful environment. Please take a moment to review each section carefully before submitting your form.

1. Nature of the Service
 

Ear irrigation is a non-invasive nursing procedure designed to safely remove cerumen (earwax) and debris from the external ear canal using controlled, low-pressure warm water irrigation. The procedure is performed by a Registered Nurse utilizing sterile technique and professional-grade equipment. Ear irrigation is not a diagnostic medical procedure and does not replace the need for routine examination by a physician or otolaryngologist (ENT specialist).

 

2. Pre-Procedure Assessment and Right to Refuse Service
 

Prior to performing ear irrigation, the nurse will conduct a brief ear health examination to visually assess the external ear canal and tympanic membrane (eardrum) for signs of infection, injury, inflammation, or obstruction. If at any point the nurse determines that ear irrigation is contraindicated, including but not limited to the presence of:

• Active ear infection
• Ear pain or unexplained discharge
• History of ear surgery, tubes, or eardrum perforation
• Recent head trauma or dizziness
• Impacted foreign object
• Signs of bleeding, inflammation, or other abnormalities
  
  

…the procedure will not be performed. The patient will be advised to contact their general practitioner (huisarts) or a licensed medical provider for further evaluation and treatment.

The Ear Clinic NYC reserves the right to decline or discontinue service at any time if proceeding may result in patient harm or if the patient fails to disclose pertinent medical history. This policy is in place to protect both the patient’s safety and the professional integrity of the nurse.

 

3. Patient Responsibility and Disclosure
 

The patient agrees to provide complete and accurate medical information to the best of their knowledge, including relevant ear history, medications, allergies, and chronic conditions. Failure to disclose such information may result in cancellation of the procedure and forfeiture of payment.

 

4. Possible Risks and Side Effects
 

 While ear irrigation is a generally safe and well-tolerated procedure, mild temporary side effects may occur, including:

• Sensation of fullness or water in the ear
• Mild dizziness, vertigo, or nausea
• Temporary hearing changes
• Slight discomfort or sensitivity
• Traces of redness or irritation
   

Serious complications (such as eardrum perforation, infection, or persistent pain) are extremely rare but possible. Should any of these occur, the patient agrees to seek immediate medical attention from their general practitioner or emergency department.

The Ear Clinic NYC, its nurses, and affiliates shall not be held liable for complications arising from undisclosed conditions, noncompliance with aftercare instructions, or the patient’s failure to follow medical advice.

 

5. Confidentiality and Data Protection
 

All information collected through this form and during the visit is confidential and used solely for patient care and clinical documentation.

Ear Clinic NYC adheres to privacy and data protection principles consistent with HIPAA (Health Insurance Portability and Accountability Act) and international nursing confidentiality standards.

Patient records are securely stored, accessible only to authorized clinical personnel, and will never be shared or sold to third parties without written consent, except as required by law.

 

6. Payment and Cancellations
 

 Payment is due at the time of service unless arranged in advance. Appointments canceled with less than 12 hours’ notice may be subject to a cancellation fee. No refunds will be provided for missed appointments without notice.

 

What to Expect During Your Visit
 

Assessment and Examination

Upon arrival or at the start of your home visit, the nurse will perform a brief ear assessment using an otoscope to visualize the ear canal and eardrum. This evaluation determines whether ear irrigation is safe and appropriate for you.
Procedure Explanation and Consent

The nurse will explain the irrigation process, expected sensations, and safety measures. You will have the opportunity to ask questions before the procedure begins. No irrigation will be performed without your signed consent.
Ear Irrigation Procedure

The nurse will gently introduce body-temperature water into the ear canal using sterile irrigation equipment. The goal is to soften and flush out wax buildup or debris while maintaining comfort and safety throughout the procedure.
Post-Procedure Evaluation

After irrigation, the nurse will reassess your ears to ensure the canal is clear and intact. You will be informed of the findings and advised on appropriate aftercare.
 

Aftercare Instructions
 

1. Avoid inserting any objects (cotton swabs, fingers, or tools) into the ears for at least 24 hours after irrigation.
2. Keep ears dry for 12–24 hours; avoid swimming or submerging the head in water.
3. If mild soreness or fullness occurs, it should resolve within a few hours.
4. If pain, discharge, dizziness, or hearing loss develops, contact your nurse or your general practitioner immediately.
5. For ongoing ear health, routine professional cleaning is recommended every 6–12 months, or as advised by your provider.
    

By submitting this form, you consent to the terms outlined above and authorize the Registered Nurse to perform ear irrigation in accordance with professional nursing standards.

By signing below, I confirm that I have read and understood the Terms, Disclaimer, and What to Expect section provided by The Ear Clinic NYC. I acknowledge that I have disclosed accurate medical information and that ear irrigation will be performed only if deemed safe by the attending Registered Nurse. I understand that the nurse may refuse or discontinue the procedure at any time if it is contraindicated or unsafe to continue. I consent to treatment, accept the possible risks, and agree to follow all aftercare instructions provided. I understand that The Ear Clinic NYC maintains confidentiality consistent with professional nursing and international data privacy standards. I hereby authorize the Registered Nurse to perform ear irrigation and any related assessment necessary for my care.

For your safety and accurate medical documentation, please upload a clear photo of a valid government-issued ID (such as a passport, driver’s license, or local identification card). This is required for patient verification, recordkeeping, and compliance with professional medical standards. Your identification is used solely to confirm your identity and to maintain accurate, confidential health records. The Ear Clinic NYC upholds strict privacy and data protection protocols consistent with HIPAA and international nursing confidentiality standards. Your ID image will remain securely stored, accessible only to authorized clinical personnel, and will never be shared or used for any non-clinical purpose.