The following is a list of forms we ask that you print and complete before coming for your visit. Completing these forms in advance will save you time upon arrival at the office and help us expedite your visit. Please COMPLETE ALL BLANKS on each form in BLACK INK. To download a form, right click the form below, choose "Save As" and save it to your computer.
- Welcome to Our Office (Patient Registration & History)
- Our Financial Policy
- Medicare Signature on File
- Visual Field Screening Exam
- iWellness Exam
- E-Mail Consent Form
- Privacy Policy Consent Form
NEW PATIENTS - ALL NEW PATIENT REGISTRATION FORMS MUST BE E-MAILED TO THE OFFICE IMMEDIATELY AFTER SCHEDULING OR YOUR APPOINTMENT WILL BE CANCELLED.
After completing the forms above, you may call our office and schedule an appointment, or Schedule Your Appointment On Line Now. Please e-mail the forms back to us at info.beareye@yahoo.com.
Please note: All files are in PDF format and can be viewed with Adobe Acrobat Reader.
If you do not already have this viewer, you may download it at no cost from
Adobe's Web site.