Patient Forms

If you are a new patient to our office, the attached 3 files contain our new patient bundle with forms that need to be filled out before arriving at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. 

If you are an existing patient to our office and have had any changes to your name, address, and/or phone number, please fill out the patient information page and bring it with you to your appointment.

Also, all patients need to fill out the new updated HIPAA privacy form. Please include: email, phone numbers, and the names of any friends/family that we may release medical information or your purchases to on your behalf.

 

 

Patient Forms

  1. Patient Information
  2. About Your Eyes
  3. Hippa Privacy Form  - To read the full HIPAA Privacy Act Click Here.
  4. Cancellation Policy

 

This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.