Patient Forms
| Hipaa/Privacy Form |
Every Patient is required to fill out this form. You can fill it out before you arrive and cut down on the amount of paperwork to fill out. We will give you a Pamphlet Re: the Privacy Rights upon arrival.
| VSP Insurance Form |
For those with VSP or Vision Service Plan, please fill out this form before you come in to cut down your time filling out paperwork.
NOTE: At this time, we are unable to pull this form up. Sorry for the inconvenience.
NOTE: At this time, we are unable to pull this form up. Sorry for the inconvenience.
| Medicare Form |
All Medicare Patients are required to fill out the MEDICAL HISTORY form and can fill it out in the privacy of your home with no time limit. Just fill it out, there's two pages and bring it in when you come in for an exam. We have to do this once a year.
If you have already filled one out you can make changes on your previous copy in red ink upon arrival or write: no changes if everything is the same, sign, and date it as well.
If you have already filled one out you can make changes on your previous copy in red ink upon arrival or write: no changes if everything is the same, sign, and date it as well.