Sharp Eyes Family Vision Center

PATIENT FORMS

At Sharp Eyes Family Vision Center, we value your time. If you wish, you may download and complete our patient form(s) prior to your appointment.

PATIENT HEALTH HISTORY FORM

Please complete this form so that we understand your history and your current health. You may also leave any questions, comments, or long-term goals that you have for your continued vision health.

NEW PATIENT PDF

HIPAA RELEASE FORM

Please fill out this form to disclose your personal information. This information may be used for medical treatment or consultation or for billing purposes or at the
request of the individual.

HIPAA RELEASE PDF

PATIENT FORMS

At Sharp Eyes Family Vision Center, we value your time. If you wish, you may download and complete our patient form(s) prior to your appointment.

PATIENT HEALTH HISTORY FORM

HIPAA RELEASE FORM

INSURANCE INFORMATION

We have partnered with a variety of insurance carriers and offer several flexible payment plans. To verify your insurance carrier or vision care plan, please call our office. We are also more than happy to discuss payment plans.