Please print and complete the following forms before your first appointment. You can print the complete forms package (14 pages) or each form individually.
Complete Forms Package
- Patient Referral Form
- New Patient Information
- New Patient Medical Information
- Medical Records Release
- HIPAA Notice of Privacy Practices
- HIPAA Notice to Patients
- HIPAA Appointment Designate
Amsler Grid Testing
Amsler Grid Testing is an at-home test to help detect changes in your vision, the Amsler Grid test can be an important indicator of diseases in the retina.