Patient Forms

 

NEW PATIENTS

Please download, complete, and print the following 5 documents. Bring these with you to your appointment. 

Patient Registration

General Consent to Treat

Refraction Notification

Assignment of Benefits

Medical History Questionnaire

HIPAA*

*This document only needs to be read, not printed


ADDITIONAL FORMS

If records from another facility need to be released to our office, 
please complete and print the following Medical Record Release form.

Permission to Discuss Medical History

Medical Record Release