PATIENT CENTER
APPOINTMENT INFORMATION AND FORMS
Remember to bring with you the following items:
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Medical and Vision Insurance Cards if applicable
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Photo ID
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Current glasses (even if just over the counter readers)
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Contact lenses (wear into exam and bring prescription information)
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Complete list of medications and allergies
NEW PATIENT PAPERWORK
Please complete all of the following forms prior to your appointment.
If you are unable to complete the google forms, please print, complete, and e-mail us back a copy of your forms.
Authorization for Release of Medical Records
Release of Personal Health Information
Please reference the information sheets below if you are a contact lens wearer.
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 $50.
Late Arrivals
Please arrive on time for your scheduled appointment. Out of respect for the doctor and other patients, patients arriving more than 10 minutes after their scheduled appointment may be asked to reschedule, Late cancellation fee will apply.
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 or could have 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 at the time of service.