Please print these forms and complete before your appointment. The first two pages are the patient information forms used by all our patients to list their name, address, insurance information, medical and eyecare history, medicines used, etc. The third page is a required HIPPA (Notice of Privacy Practices) form to be signed after reading the privacy notice either in our office or on the bottom of this web site's home page. Thanks for helping us more efficiently serve you at our office.
Download an electronic copy of our most recent "The Eye Opener" newsletter.
Use these forms to release you information from other offices to our office or vice versa. First Page Displayed: Use for having another office release your records to our office. Middle Page Displayed: Use to have your records released from our office to another provider/ entity. Last Page Displayed: Use to authorize others to have access to your protected health information.
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