Download Patient Forms
New patients that are 16 years of age and older will need to print out 3 forms(Medical History Record, FHV Insurance/Liability Form and Digital Retinal imaging). Existing patients and children 15 and under will need to print out (FHV Insurance/Liability Form and Patient update/HIPAA Form). The Retinal imaging Form is for patients 16 and older. If interested in Digital Retinal Imaging please print out and bring in with you for your exam.
| fhv-insurance-and-liability-form-2023__2_.pdf |
| medical_history_record_2023.pdf |
| patient_update_and_hipaa_2023.pdf |
| digital-retinal-imaging__4_.pdf |
Cancellation Policy
| web_site_cancellation_policy_1.pdf |
Permission to Treat Form
If your child is under the age of 18 and you would like them to be seen in our office without you being present, please print out the form below and have your child bring this form in for their appointment.
If your child is under the age of 18 and you would like them to be seen in our office without you being present, please print out the form below and have your child bring this form in for their appointment.
| permission_to_treat_minor_2024.pdf |