Forms

Refractive Surgery Questionnaires

• Refractive surgery questionnaire 10-6-11
• Refractive Lens Exchange Questionaire 7-25-06

New Patient Forms

• New patient information sheet 10-6-11
• AECA Payment policy-assign benefits-refraction-HIPAA 10-17-11
• HIPAA policy notice
  (please read but it is not necessary to print-out)

Established Patient Forms

• Medical update sheet with refraction and appointment policy

 

All forms are in Adobe PDF format
Use this link to download the Free Adobe Acrobat Software