PATIENT CENTER  

APPOINTMENT INFORMATION AND FORMS

Remember to bring with you the following items:

  • Medical and Vision Insurance Cards if applicable

  • Photo ID

  • Current glasses (even if just over the counter readers)

  • Contact lenses (wear into exam and bring prescription information)

  • Complete list of medications and allergies

NEW PATIENT PAPERWORK

Please complete the following forms prior to your appointment.

History Form

Privacy Policies Consent Form

Release of Personal Health Information

If you are unable to complete the google forms, please print, complete, and e-mail us back a copy of your forms.

       History Form

       Privacy Policies Consent Form

       Authorization for Release of Medical Records

       Release of Personal Health Information

Please reference the information sheets below if you are a contact lens wearer.

       Contact Lens Information Sheet

       Contact Lens Training Information

OFFICE POLICIES

Appointment Cancellations

If you need to reschedule or cancel your appointment please notify our office at least 24 hours in advance, if not you are subject to a late cancellation/no show fee. The current fee is $25 for daytime appointments, and $50 for appointments in high demand time slots, after 4pm and on Saturday.

Medical Insurance/Vision Plan 

There are two types of plans that may help cover the cost of eye care services and materials. Our practice accepts both medical insurance and vision plans. Vision plans only cover routine vision exams along with eyeglasses and/or contact lenses. Medical insurance must be used if you have any eye health problem that has ocular complications. Your doctor will determine if these conditions apply to you, but some are determined by your case history. In summary, how your eye exam will be submitted to your insurance carrier will depend not only upon what you tell the doctor, but also what the doctor finds upon examination. According to your insurance plan, you are responsible for any and all co-payments, deductibles, and co-insurances.

Call or click to schedule an appointment today!

860-531-3852

VISIT US

752 Middletown Road 

Colchester, CT 06415

CALL OR TEXT US

Tel: 860-531-3852

Fax: 860-468-4235

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