Patient Forms

Welcome Form 
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About Your Insurance

HIPAA Acknowledgement

​optomap_patient_sheet__2_.docx
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​Notice of Privacy Practices

Insurance

We work with a wide variety of medical and vision insurance companies.  

We will verify your eligibility in the office or you can contact us before

your visit, if you have any questions regarding your insurance.  
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We will be glad to file your claims for you. 

 

 Care Credit is available in our office.

​Visit http://www.carecredit.comfor more information.
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        Vision Care Direct is a unique vision plan that we endorse.

​ www.visioncaredirect.com

Financial assistance for medicines

Follow the links below if you cannot afford your medication

                               www.rxassist.org                                      

                            www.rxhope.com                                   

​www.needymeds.org
     
           

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