Patient Forms

As a new patient to our practice, we would like to offer a warm welcome and our thanks for choosing us to provide your eye health and vision care. In order for us to provide the most beneficial use of your time with us, your doctor has asked you to complete the following tasks and bring the results to your appointment. Your doctor needs this information in order to give you the best care possible.

  • Completed Medical and Eye Health History: Since many general health conditions may be associated with visual symptoms and/or eye health problems, this important record will allow us to care for you as a “whole person” rather than just a pair of eyes. New Patient Forms
  • Payment Policy: Payment is due at the time of service. We accept personal checks, cash, Visa, MasterCard, and Discover. We also offer an extended payment plan with Care Credit pending approval. If you have any questions regarding this policy, please call the office prior to your appointment.
  • Insurance: Please bring all insurance cards with you. If you believe that you have routine vision coverage, please research this and let us know what the routine coverage is prior to your appointment. If you are unaware of routine vision benefits, we will have to file medically or collect in full for the services at the time of your examination. Insurances Accepted
  • Eyeglasses: Please bring ALL pairs of eyeglasses you currently use, including prescription or non-prescription reading glasses, sunglasses, etc. By doing so, we can evaluate the condition and fit of your current eyewear.
  • Contact Lenses: If you wear planned replacement or disposable lenses, it is very helpful if you bring along your boxes or lens packets that indicate the lens series, power, manufacturer, etc. Contact Lens Forms
  • Eye drops, Ointments, Etc: Please bring any eye drops or ointments that you use along with you. Your doctor will review whether these are appropriate or if a better option is available.
  • Privacy Practices: Please click here for a copy of our privacy practices. Contact Meredith Puzio, HIPAA compliance officer, at either practice with any questions.