Patient Forms

Please fill out the following patient information forms and bring them with you to your first visit. Signing "Acknowledgment of Receipt of Privacy Practices" on the form signifies that you have read the Privacy Policy, listed below.

New Patient Medical History FORM

financial agreement FORM

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PROTECTED HEALTH INFORMATION RELEASE FORM

NO SHOW/CANCELLATION POLICY FORM

REFRACTION/DILATION FORM

PATIENT RELEASE OF RECORDS TO ATLANTIS

PATIENT RELEASE OF RECORDS FROM ATLANTIS

Notice of Privacy Practices

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Insurances we accept