Patient forms.
Please print and complete these forms before your visit to save time at check-in. If you can't print at home, we'll provide copies when you arrive.
01
Patient Information
General information form for new patients.
PDF →
02
Insurance Information
Insurance and contact information form.
PDF →
03
Financial Credit Policy
Our financial responsibility and credit policy.
PDF →
04
Authorization to Release PHI
HIPAA authorization to release your protected health information.
PDF →
05
Health e-Connections (RHIO)
Information sharing through the regional health information exchange.
PDF →
Bring on appointment day
Photo ID · Insurance card(s) · A list of your current medications · A list of any eye drops you're using · The completed forms above