Forms

New Patient Packet

Click on the link above and print the forms that we will need prior to your evaluation by our physicians. Your complete eye history and medical history, and your demographic information is required in order to examine your eyes, perform diagnostic testing, in-office procedures, and surgery, as well as submit your insurance claims. If we do not have completed information, we may not be able to complete your evaluation and we may not be able to file your insurance, in which case you will be responsible for all fees at the time of service, unless prior arrangements have been made with our Billing Department. If you are unable to complete the forms prior to your appointment, we will assist you upon arrival at our office.

 

Our Health Information Practices policy is available by clicking on the link below.

Notice of Health Information Practices