Patient information and forms are available for you to download, print, fill out, sign and return on your next visit.
Forms are created in PDF Format. Adobe® Reader® software is the global standard for electronic document sharing. It is the only PDF viewer that can open and interact with all PDF documents.
NEW PATIENT FORMS
Assignment of Medicare Benefits – Print & Fill Out
Financial Assignment Sheet – Print & Fill Out
Financial Assignment Sheet (Spanish) – Print & Fill Out
HIPAA Notice of Privacy Practices – Print & Fill Out
Patient Information Sheet – Print & Fill Out
Patient Medical Information – Print & Fill Out
Medical Records Release Form – Print & Fill Out
Cataract Surgery Questionnaire – Print & Fill Out
LASER VISION CORRECTION FORMS
CustomVue Advantage Patient Information Booklets
Facts You Need to Know About CustomVue™ Laser Assisted
In-Situ Keratomileusis (LASIK) Laser Treatment. Please read the patient information booklet completely. Discuss any questions with your doctor before you decide if CustomVue LASIK is right for you. Only an eye care professional trained in laser vision correction can determine whether you are a suitable candidate.