Patient Forms and Appointments

New Patient Registration Form

Disclosure of Information Form

Dilation Consent Form

Patient Medical History Form

In order to expedite your check-in process upon arrival, we recommend you download and print each of the PDF forms above.  Then fill-out the forms and bring them with you to your appointment.  If you plan to fill in these forms in our clinic, we recommend you arrive 15 minutes early to your appointment.

About your office visit:

  • Your eyes will be dilated for the examination.
  • You will need someone to drive you.
  • Your visit may last between 1 and 3 hours depending on the type of evaluation.
  • Diabetic patients are asked to bring a snack in case the appointment runs into their lunch or dinner time.

Please bring the following with you on the day of your appointment:

  • The completed registration forms
  • A list of all medications and eye drops that you are currently taking
  • Any contact lenses or glasses that you currently wear
  • Your current insurance cards
  • Co-pays for specialists as noted on your insurance card
  • Referrals from your primary care physician if your insurance requires a referral to see a specialist.
  • A valid picture identification card

NOTE: If Medicare is your only insurance, a co-payment will be collected at the time of the office visit. If we do not participate with your insurance, payment will be collected at the time of the office visit.