Patient forms
Please read our Notice of Privacy Practices. In summary, we will protect and keep confidential all of your personal information, such as your social security number and date of birth. If you are a NEW patient, print out and sign the HIPAA Privacy Policy Receipt and then email it back to us prior to your appointment; this will expedite your check-in time on the day of your visit.
Your eyes are a window to your health and wellness! We recommend both Pupil Dilation and Retinal Imaging as essential parts of a comprehensive eye exam. Retinal Imaging (optomap®) captures a high-resolution digital scan of the macula, retina, optic nerve, and blood vessels for the early detection of eye diseases (macular degeneration, retinal detachment, glaucoma, melanoma) as well as general health problems (high blood pressure, diabetes, stroke, cancer). The optomap® does NOT replace Pupil Dilation (the standard technique used to examine the health of the eyes) but is complementary to it and is an excellent alternative if dilation is not convenient for you at the time of your visit. Early disease detection is vital to preserving a healthy eye and body; we strongly recommend Retinal Imaging for every patient. Since the optomap® is typically not covered by vision insurance, our fee for this optional diagnostic test is $39.00.