Patient Forms

Please complete these forms prior to your visit. The Patient Information form is completed via our online portal. Please print the other forms and bring them with you to your appointment.

 

Online Patient Portal:

Patient Information (online)

 

Please print and bring with you to your appointment:

Financial Policy and Authorizations

HIPAA Acknowledgment of Notice of Privacy Practices (HIPAA Notice of Privacy Practices)

Contact Lens Fitting Agreement (new or previous contact lens wearers)

Wellness Screening Information

Medical Eye Examination versus Vision Eye Examination

Medical Records Release Authorization Form

Minor Consent Form

 

HIPAA Notice of Privacy Practices for Patients (informational only):

HIPAA Notice of Privacy Practices