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.
Additional Forms

Patient Information | |
File Size: | 497 kb |
File Type: |
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: |
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: |
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: |
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: |
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: |