(208) 888-2200
(208) 888-7623
info@meridianeyecare.com
1648 W 2nd Street Meridian, ID 83642
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Patient Forms

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

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Welcome-to-office

The Welcome to the Office Form is a basic information form with your contact information and insurance information.
Size: 69.77 KB
Hits: 105
Date added: 29-01-2021
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Review-of-Systems

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.
Size: 45.78 KB
Hits: 86
Date added: 29-01-2021
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Medical-Questions

The Medical Questionnaire Form lets us know about your previous medical history so we can ensure you receive the proper testing and care.
Size: 47.90 KB
Hits: 94
Date added: 29-01-2021
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2017-HIPAA-privacy-practices

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).
Size: 61.29 KB
Hits: 76
Date added: 29-01-2021
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2017-HIPAA-Disclosure

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.
Size: 35.18 KB
Hits: 77
Date added: 29-01-2021
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2016-Release-of-Confidential-Information

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.
Size: 48.20 KB
Hits: 98
Date added: 29-01-2021
Call Meridian Family Eyecare at 1-208-888-2200 ~ The Treasure Valley's trusted source for general eye care, glasses, contact lenses, and more - for the whole family!
Copyright All Rights Reserved © 2018 Meridian Family Eyecare
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