Download Our Patient Forms

What to bring with you to your exam

Please download, print, and complete the patient history and consent forms, below. Our HIPAA privacy policy is also available for viewing or download on this website. Don’t worry if you don’t have everything filled in. We’ll help you complete the form when you arrive.

New Patient Medical History Form

Insurance Release and HIPAA Acknowledgement

Retinal Imaging Consent

View our HIPAA Privacy Policy.

 

Please also bring:

  • Any current prescription eyewear, including sunglasses
  • Current contact lens boxes, if you wear contacts
  • A medication list, if you currently take any prescription medications
  • Your medical insurance card