alarm-ringing ambulance angle2 archive arrow-down arrow-left arrow-right arrow-up at-sign baby baby2 bag binoculars book-open book2 bookmark2 bubble calendar-check calendar-empty camera2 cart chart-growth check chevron-down chevron-left chevron-right chevron-up circle-minus circle city clapboard-play clipboard-empty clipboard-text clock clock2 cloud-download cloud-windy cloud clubs cog cross crown cube youtube diamond4 diamonds drop-crossed drop2 earth ellipsis envelope-open envelope exclamation eye-dropper eye facebook file-empty fire flag2 flare foursquare gift glasses google graph hammer-wrench heart-pulse heart home instagram joystick lamp layers lifebuoy link linkedin list lock magic-wand map-marker map medal-empty menu microscope minus moon mustache-glasses paper-plane paperclip papers pen pencil pie-chart pinterest plus-circle plus power pushpin question rain reading receipt recycle reminder sad shield-check smartphone smile soccer spades speed-medium spotlights star-empty star-half star store sun-glasses sun tag telephone thumbs-down thumbs-up tree tumblr twitter user users wheelchair write yelp youtube

Patient Forms

Welcome! We know you’re busy…but COVID-19 has changed a lot of things. The following tips will help us serve you safely and more efficiently.

  1. The link to our secure, encrypted, online information form for ALL patients is below. This needs to be submitted at least 24-hours prior to your appointment time. If you are unable to complete it, please let us know as soon as possible.
  2. Every patient will need to bring a mask and must wear it all times.
  3. Only the patient being seen will be allowed in the office. If you need assistance during your exam, please let us know BEFORE you arrive. Patients under the age of 18 will need to have an adult with them.
  4. Our secure text feature will allow you to send us a photo of your insurance card.  We also need this prior to your appointment and will contact you directly with an easy how-to.
  5. To save time in the office and maintain social distancing, plan to pay any co-pays, deductibles and uncovered charges in advance of your appointment. We will contact you with instructions. When we have your correct insurance information three (3) business days prior to your appointment, we will gladly file your visit to your vision or medical plan, as applicable. Any co-pays or deductibles will apply. Without pre-verification, full payment for all services is expected at the time of your visit. We will still be happy to file to your insurance for your reimbursement.  We accept Visa, MasterCard, American Express, Discover and Care Credit.
  6. If you are not familiar with our location, click here. Please don’t depend on your GPS system to find our office. The Ridge Office Park is a new development and is not listed on many systems. If you still need help, please call our office in advance of your appointment and we will help you find us.
  7. If you are a contact lens wearer, please wear your contact lenses to your appointment. It is also helpful if you bring your back-up glasses, too.
  8. If you wear glasses, please bring your most recent pairs of glasses and prescription sunglasses to your appointment.
  9. Please be aware that many medical insurance plans, including standard Medicare, do not cover refraction (the process of determining the prescription used for glasses and contact lenses). The refraction fee is $48 which is due at the time of service if not being filed to insurance. Please contact us at least 48 hours in advance of your appointments if you have further questions about possible charges for this service.
  10. We strive to run on time because we don’t like waiting for hours in a doctor’s office, either. Patients who are late for their appointments cause us to be behind schedule for every other patient the rest of the day. If you are late for your appointment, we will help you find a time that is more convenient for your schedule.
  11. So we may better serve all of our patients, kindly give 48 hours’ notice if you need to reschedule your appointment. A credit card may be required to hold future appointments when cancelled or rescheduled with less than 24 hours’ notice, or if you miss your appointment entirely. A $75 no-show fee will be charged to this card for any future missed appointments.
  12. All patients under the age of 18 must be accompanied by a parent or guardian throughout their entire visit.  Howard and the Amazing Eye Exam is a fun, interactive eBook parents can download to explain the eye exam experience to young children.  To download the book for free, click here.                                                                                                                                           Howard
  13. Please alert our staff as soon as possible to any special needs or disabilities of which we should be aware.

Our Forms