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.
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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
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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 before your scheduled time, if not you are subject to a late cancellation/no show fee. The current fee is $50 for any missed appointments.
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Late Arrivals
We kindly request that you arrive promptly for your scheduled appointment. To ensure the doctor's schedule and the convenience of other patients, individuals arriving more than 10 minutes late will be asked to reschedule their appointment. If you anticipate being unable to arrive on time, please call in advance to notify us. Your cooperation is greatly appreciated.
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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.