For your convenience, this section contains several important items which you should read before you visit the Center for Sight. Answering these questions and signing the documents now can save you time during your visit.
The paperwork includes an Intake Form, a Medical Questionnaire, Signature on File, Assignment of Benefits, Financial Agreement, Notice of Nondiscrimination, Form Release Fee Policy, Consent to Use/Disclose Protected Health Information, and HIPAA Policy.
Our online patient forms are available in PDF format for your convenience. Just click on the links below, print out the forms, fill them out and bring them with you.
- Intake Form
- Medical Questionaire
- Center for Sight’s Notice of Privacy Practices
- Notice of Nondiscrimination
- Form Release Fee Policy
- Signature on File, Assignment of Benefits, Financial Agreement
- Consent to Use Disclose Protected Health Information
*Please be aware that you will be asked to fill out each of the above documents if you have not been seen at Center for Sight for 6 months or more. This is to ensure the accuracy of the information that is documented for your safety and security. Everything we do is to better serve you.
All new patients are required to fill out one of each form indicated on this page. We understand that your time is valuable. To lessen the duration of your first visit at Center for Sight, print and fill out each of these forms. We look forward to serving you.