HERE ARE THE PATIENT FORMS TO FILL OUT AND BRING WITH YOU TO YOUR APPOINTMENT.

Your confidence in us is important.  We safeguard your confidential medical and personal data.  We never release your information to third parties, other than your insurance company or your physician to assist in your care.  If you would like to read our privacy policy, please click here to view (and print if you would like):

If you need to have medical records from your prior eye care provider sent to us, or your information from us sent to another provider, print out this form, fill it out, sign it, and bring it in to us:

ALL NEW PATIENTS SHOULD PRINT OUT THE FOLLOWING FORMS, FILL THEM OUT AND BRING THEM TO THE APPOINTMENT:

The consent form is required by law.  It states that you have received the Privacy Policy above which informs you of how we use your confidential information.

The Welcome to the Office Form is a basic information form with your contact information and insurance information.

The Medical Questionnaire Form lets us know about your previous medical history so we can ensure you receive the proper testing and care.

The Review of Systems Form is medical background information that insurance requires which helps us to determine your medical status for eye health testing and examination.

Contact Us

You can send us an email and we'll get back to you, asap.

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