Patient Resources

Online Patient Forms

You can fill out your forms before you come in using the link below. Be sure to click “Submit” when you’re finished and the information will be sent directly to our office; there’s no need for a printer! If you’re unable to submit your forms online, please come in 10 minutes ahead of your scheduled appointment time.

Patient Forms (Goes to External Website)

Printable Patient Forms

For your convenience, you can also print the following forms and fill them out before visiting us.

Patient History Questionnaire (PDF)
Contact Lens Agreement (PDF)
Financial Responsibility & Privacy Acknowledgment (PDF)

HIPAA Notice of Privacy Practices

HIPAA Notice (PDF)

Insurances Accepted

We currently accept the following vision plans:

  • Advantica
  • AlwaysCare
  • Avesis
  • Blue Cross Blue Shield
  • Davis Vision
  • EyeMed
  • First Look
  • Heritage
  • Humana
  • Medicaid
  • Medicare
  • MESVision
  • MultiPlan
  • Prime Health
  • Spectera
  • Superior
  • UMR
  • VSP