The Eye Clinic
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    • Home
    • Locations
    • Optical
    • Patients
      • Patient Portal
    • Billing & Insurance
    • Patient Forms
  • Home
  • Locations
  • Optical
  • Patients
    • Patient Portal
  • Billing & Insurance
  • Patient Forms

Downloads

Download Patient Forms Here!

COMMON WELL PT RECORDS (pdf)Download
PAYDAR OR MILLER- PAPERWORK FOR COMMERCIAL OR MEDICARE ADVANTAGE INSURED PATIENTS (pdf)Download
PAYDAR OR MILLER- PAPERWORK FOR MEDICARE INSURED PATIENTS (pdf)Download
RELEASE OF RECORDS TO THE EYE CLINIC FROM ANOTHER DR (pdf)Download
RELEASE OF RECORDS TO ANOTHER DR FROM THE EYE CLINIC (pdf)Download
HIPAA NOTICE (pdf)Download
MEDICARE AUTHORIZATION (pdf)Download
PATIENT INFORMATION (pdf)Download
REFRACTIVE EXAM ACKNOWLEDGEMENT (pdf)Download

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