Disability/FMLA Request

Complete Your Disability/FMLA Request
  1. Please click the link below to begin the disability/FMLA form process; Please DO NOT bring forms to the practice to turn in.
  2. Make sure to have your disability or FMLA form with you BEFORE logging in! (You should have received these forms from your disability carrier or employer). No forms are provided on this link.
  3. Normal turnaround time to receive your completed form is 5-7 business days. There is an additional fee for expedited requests.  Forms not submitted through this link could result in a slower turnaround.
  4. You will be asked for payment on this page as well. The cost is $30 per form, $15 for an updated form and $50 for an expedited request (guaranteed 3 day turnaround).
  5. FMLA and Disability forms cannot be completed on the same request. These forms must be submitted separately.
  6. For any further questions, please contact us via text or phone call at 504-977-0343. Text messages will provide a quicker response.
Click Here to Upload & Process Your FMLA or Disability Form
Our Locations

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Request Appointment
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ENT & Allergy of New Orleans is located in greater New Orleans, Drs. Fatakia, Irwin, and Qayum provide the latest in surgical and medical treatment to meet your NOLA ENT needs.

Address: 1151 Barataria Blvd Suite 3100, Marrero, LA 70072

We also provide ENT services in Chalmette, Hammond & Metairie location.

Timings: Monday - Friday: 08:00 AM - 17:00 PM
Call Us Today:
504-229-6612
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Looking for urgent ENT walk-in care?
Visit our Chalmette, & Metairie locations.