alarm-ringing ambulance angle2 archive arrow-down arrow-left arrow-right arrow-up at-sign baby baby2 bag binoculars book-open book2 bookmark2 bubble calendar-check calendar-empty camera2 cart chart-growth check chevron-down chevron-left chevron-right chevron-up circle-minus circle city clapboard-play clipboard-empty clipboard-text clock clock2 cloud-download cloud-windy cloud clubs cog cross crown cube youtube diamond4 diamonds drop-crossed drop2 earth ellipsis envelope-open envelope exclamation eye-dropper eye facebook file-empty fire flag2 flare foursquare gift glasses google graph hammer-wrench heart-pulse heart home instagram joystick lamp layers lifebuoy link linkedin list lock magic-wand map-marker map medal-empty menu microscope minus moon mustache-glasses paper-plane paperclip papers pen pencil pie-chart pinterest plus-circle plus power pushpin question rain reading receipt recycle reminder sad shield-check smartphone smile soccer spades speed-medium spotlights star-empty star-half star store sun-glasses sun tag telephone thumbs-down thumbs-up tree tumblr twitter user users wheelchair write yelp youtube

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

 

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

HIPAA Notice of Privacy Practices