HAMILTON MILL EYE CARE
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Secure Online Forms

Save time during your appointment by completing your patient information online.  You will need to print, fill, and sign some of the forms below to complete your patient registration.  Login or create your account below to begin.
Online Forms

Additional Forms

Patient Information
File Size: 497 kb
File Type: pdf
Download File

If you have logged in and filled out the patient form through our online portal above, you do not need to print and fill out this form.

Contact Lens Assessment & Evaluation
File Size: 131 kb
File Type: pdf
Download File

This document outlines our policy on contact lens assessment and evaluation.  No signature is required on this document and only needs to be printed for your record.

Signature Document for Consent
File Size: 109 kb
File Type: pdf
Download File

This document provides consent for Patient Portal Access, Retinal Imaging, Contact Lens Evaluation & Assessment, and Financial Policy Acknowledgement.  Please print, fill, and sign.

Notice of Privacy Practices
File Size: 311 kb
File Type: pdf
Download File

This document is for your record and it describes how your medical information is used and disclosed and how you can obtain access to this information.

HIPAA & Privacy Practice Acknowledgement
File Size: 34 kb
File Type: pdf
Download File

This document requires a signature to acknowledge the notice of privacy practices and HIPAA.  Please print, fill, and sign.

Policies

No Show/Cancellation Policy
File Size: 272 kb
File Type: pdf
Download File

  • Home
    • General Info
    • Patient Registration/Forms
    • Vision Vs Medical Insurance
  • COVID-19 Updates
  • About Us
    • Our Doctors
    • Our Team
    • Our Opticians
  • Our Services
    • Eye Care Services
    • Optical Services
    • Contact Lens Services
  • Order Contact Lenses
  • Blog/Resources
    • Eye Care Resources
    • Learn About Your Eyes