Patient Forms & Documents

Information For Our Patients

The registration and initial history forms that one can download from this page, print, and complete are for all of our new patients. It is often helpful to have them completed before you arrive for your first consultation, but the forms can also be completed when you arrive at the office. If you are coming for your first visit and plan to complete the Registration and History forms at the office, we recommend that you arrive ten to fifteen minutes early.

If the condition for which you are being seen is work-related and will be handled as a Worker’s Compensation Case, please also complete the Workers’ Compensation form and bring it with you to your visit.

For the details of our compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), please download and review our privacy policy in either English or Spanish. After reviewing and signing our privacy policy, please sign our Acknowledgement of Receipt of Notice form in either English or Spanish acknowledging that you received our medical practice’s Notice of Privacy Practices.

Dilating drops are used to dilate or enlarge the pupils of the eye to allow the ophthalmologist to get a better view of the inside of your eye. Please complete our Dilation Consent form and bring it with you to your visit.

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here: openpaymentsdata.cms.gov. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

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Patient Forms & Documents

Information For Our Patients

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