CITY CENTER OPTOMETRY - Patient Forms

CITY CENTER OPTOMETRY - Patient Forms

CITY CENTER OPTOMETRY

Appointment Scheduling

Eye Care Articles

LASIK Co-Management

Order Contact Lenses

Patient Forms

Patient Registration Form

This form is required for ALL new patients, regardless of insurance status.

Patient History Questionnaire

This form is required for ALL patients on each examination visit, regardless of insurance status.

HIPPA Notice of Privacy Practices

This form is required for ALL new patients, regardless of insurance status.

VSP Patient Consent Form

This form is required in order for our office to bill Vision Service Plan on behalf of the patient.

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Notice of Privacy Practices