Patient Forms

Tips for your visit:
1. Please arrive 15 minutes early for your appointment
2. Please bring your insurance card and photo ID to your appointment
3. For a complete eye exam, it is recommended that you have a dilated eye exam.
– If you have not been dilated before, please bring a driver with you to your appointment.
– If you have been dilated before and you experienced trouble with your vision afterwards, please bring a driver with you to your appointment.
– Remember, you will need sunglasses after a dilated exam and your eyes will be light sensitivity and may be blurry until the dilating drops wear off which may be several hours.
4. If you have a high deductible insurance plan and you have not met your deductible, you may be responsible for $200 on the day of your visit.  Please visit the Insurance tab to see if we are participating in your insurance plan.

Please find our standard new patient forms below.

New Patient Paperwork
Please complete this packet if you are new to our practice.

Release of Information Form
If you would like us to get your records from another doctor’s office or release information to another doctor’s office other than your referring or primary care doctor.

Credit Card Authorization Form
If you would like us to keep a credit card on file for any balance due

Notice of Privacy Practices