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Click on the links to open a patient form. Use the print button to print these forms to fill out. Our forms can be viewed with Adobe Acrobat Reader.
Get Adobe Reader
Welcome to Medical Center Ophthalmology. We invite you to read our welcome letter, which explains our office policies. Before coming to your first appointment at our office, please fill out the new patient forms, with the applicable disclosure form.
1. Print and complete New Patient Forms
2. Print and complete the applicable form: Medicare Disclosure Form OR Commercial Insurance Disclosure Form
3. Print and sign our Notice of Privacy Practices
If you have not been seen in over a year, or if there has been any change in your personal information and/or your medical history, please print and complete the above New Patient forms and bring with you to your appointment.
If you are an established patient and would like to re-order contact lenses, please select one of the two options below:
Place an order for contact lenses online
or
Print and fax a contact lens re-order form
If you have been evaluated by one of our physicians, and you are planning LASIK, LASEK, or PRK, you would have received a folder with several different forms to prepare you for your surgery. If you are missing any of these forms, you can download them here.
Pre-op Refractive Instructions
Post-op Refractive Instructions
Pre-op Refractive Questionnaire
Post-op Refractive Questionnaire
LASEK-PRK Consent Form
LASIK Consent Form
Cataract Surgery with Multifocal Lens Implant Consent Form
Copyright 2005, Medical Center Ophthalmology and krWebDesign |