 |
|
|
| |
| Download Forms |
|
Prior to your visit to our office, please fill out the appropriate forms below. All forms are in Microsoft Word format. Please contact us if you have any questions.
Comprehensive Eye Exam (Word document)
Every patient must fill out this form. Please fill out the top two thirds of the first page.
Contact Lens Exam (Word document)
This form is only applicable to those patients who wear contacts now, and are scheduled for a 'Comprehensive Eye Exam with a Contact Lens Evaluation'. In addition to the Comprehensive Eye Exam form above, please fill out the top half of the page.
Notice Of Privacy Practices (Word document)
Please keep the first two pages for your records, and to sign the third page and bring it to your appointment.
Release Authorization (Word document)
Please fill out this form if we request authorization for the release of your health information.
|
|
|
|
|
|
|
|
|
