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New Patient Forms

To prepare for you upcoming appointment, we ask you to have these forms filled out upon arrival.

  • HIPAA History [PDF] – The health history-HIPAA form needs to be filled out and to be turned in on your first visit. Patient general health is important because many systemic conditions are related to eye health and vision.
  • Notice of Privacy HIPAA COMPLIANCE [PDF] – The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information.
  • Release of Information [PDF] – A HIPPA medical release form is signed to allow other individuals or organizations to have access to a patient’s personal medical records, medical history, and health information. A patient must sign it voluntarily to grant access to outside individuals.