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Paperwork is available to be filled out electronically - please inquire with us when scheduling.

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 will have sent the below items electronically to you prior to your appointment. You will need to complete the following tasks and submit them back to us prior 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. 
  • 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. 
  • 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. 
  • 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: You will also receive a copy of our privacy practices. Contact Meredith Puzio, HIPAA compliance officer, at either practice with any questions.

Insurances Accepted

As a service to our patients, we are a provider for a wide variety of insurance plans. The following is a listing of many of the plans we participate in. We always investigate our patient’s insurance benefits and provide for them the best use of their coverage. Our office staff are always willing to address your questions and provide specific details.

 
  • Medicare

  • Blue Cross / Blue Shield

  • Harvard Pilgrim

  • VSP

  • United Health Care

  • Cigna HealthCare

  • Tufts (select plans)

  • Aetna

  • EyeMed

Paperwork is available to be filled out electronically - please inquire with us when scheduling.