Registration

We ask all new patients to complete the following forms prior to being seen by our Doctors. You can complete part of the initial paperwork online or by printing them off. Please bring completed forms along with a copy of the insurance and any additional documents we may need to the appointment.

Web  Registration
You must REVIEW your entries and then click SUBMIT in order for them to be saved. Keep your confirmation number for reference to any problems.

Financial Policy/HIPPA/Consent to Dilate Eyes (PDF)
Please print and bring to the first appointment.

New Patient Information (Paper Only) (PDF)
If you prefer to not use the Web Registration please print and bring in these completed forms.

Additional Forms

Approval to See Minor Patients without a Parent/Guardian Present (PDF)
If your child will be attending an appointment without the parent and/or legal guardian, we require the document above to be present during the appointment. We also require contact information to reach the parents and/or legal guardian during the exam.

Request to Release Medical Records (PDF)
Complete the form above and send to us if you would like us to obtain the patient’s records from another doctor or you would like us to send our records to another doctor.

Affiliated Organizations