NEW PATIENT Information

Please bring the following to your appointment so we can efficiently assess your needs and help give you the vision you deserve!  If you cannot print/fill out these forms before your exam, please arrive at our office 15 minutes before your appointment.

• Current glasses AND sunglasses

• Current contact lens information (you can always take a picture of the Rx information printed on the blister pack and/or box).

• Any previous eye exam records you may have

• Completed Health History form

• Completed HIPAA Privacy Policy/Insurance Signature form

• If you have Medicare, please read this Medicare Non-covered services form. Also, bring your Medicare card and any supplemental cards you may have.

IF YOU DO NOT SHOW UP FOR YOUR APPOINTMENT, WE DO CHARGE A $20 FEE.