Online Forms

At the Center for Eye Care and Optical, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Registration

Download & Print Form

Existing Patient Update Form

Download & Print Form

Financial Agreement & Refraction Fee Information

Download & Print Form

Privacy Policy

Download & Print Form

Medical Record Release

Download & Print Form

HIPPA Guidelines

The notice of privacy describes how medical information about you may be used, disclosed, and how you can get access to this information. Please review it carefully. If you have any questions about this notice, please contact our Privacy Officer.

Download & Print Form

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We look forward to hearing from you.


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