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Patient Forms
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. Please print and fill out these forms prior to your appointment.
- Medical Questionnaire
- HIPAA Release Form
- Medical Records Release
- Online Fillable Medical Records Release
*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.
New Patients
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.
