Forms

Your initial visit to our practice will include a comprehensive examination and evaluation of your retina. In order to reduce your wait time, please complete the forms located below to the best of your ability. If you are visually impaired and unable to complete the information, one of our staff members will gladly assist you at the time of your visit.

Your initial visit to our practice will include a comprehensive examination and evaluation of your retina. In order to reduce your wait time, please complete the forms located below to the best of your ability. If you are visually impaired and unable to complete the information, one of our staff members will gladly assist you at the time of your visit.

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These forms will assist our experienced back office ophthalmic technicians in documenting your past and current eye medical history and obtaining a general health history. They will then perform visual screening tests, check your eye pressure, and administer drops to dilate your pupils. The dilation process usually takes 5-10 minutes, depending on the color of your eyes.

These forms will assist our experienced back office ophthalmic technicians in documenting your past and current eye medical history and obtaining a general health history. They will then perform visual screening tests, check your eye pressure, and administer drops to dilate your pupils. The dilation process usually takes 5-10 minutes, depending on the color of your eyes.

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IMPORTANT** Due to the fact that dilation of your pupils can last anywhere from 4 to 6 hours, we recommend that you bring a driver on the day of your appointment.

IMPORTANT** Due to the fact that dilation of your pupils can last anywhere from 4 to 6 hours, we recommend that you bring a driver on the day of your appointment.

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Next, your physician will review your medical history with you and examine your eyes, paying special attention to your retina. The physician will explain the findings and, if necessary, make recommendations for additional diagnostic testing.

Next, your physician will review your medical history with you and examine your eyes, paying special attention to your retina. The physician will explain the findings and, if necessary, make recommendations for additional diagnostic testing.

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Once a diagnosis is established, your doctor will discuss your treatment options with you, address your questions and concerns, and send a report to your referring doctor, including recommendations for the course of your future eye care.

Once a diagnosis is established, your doctor will discuss your treatment options with you, address your questions and concerns, and send a report to your referring doctor, including recommendations for the course of your future eye care.

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We are committed to providing you with outstanding patient care and minimizing your wait time. Due to the complex nature of retinal diseases, your initial evaluation may take up to two hours from the time that dilation drops are administered in your eye. Subsequent visits may be 

considerably shorter, but that depends upon your individual situation and the time required for necessary diagnostic tests and/or treatments. 

We are committed to providing you with outstanding patient care and minimizing your wait time. Due to the complex nature of retinal diseases, your initial evaluation may take up to two hours from the time that dilation drops are administered in your eye. Subsequent visits may be 

considerably shorter, but that depends upon your individual situation and the time required for necessary diagnostic tests and/or treatments. 

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Because dilation of your pupils may result in blurred vision and increased sensitivity to light, please bring a pair of sunglasses with you to your appointments. Again, it is recommended to have someone drive you to and from all appointments. This is for your safety and for the safety of those around you.

Because dilation of your pupils may result in blurred vision and increased sensitivity to light, please bring a pair of sunglasses with you to your appointments. Again, it is recommended to have someone drive you to and from all appointments. This is for your safety and for the safety of those around you.

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Please bring the completed forms, along with your current insurance card(s), a photo I.D. or Driver’s license, list of medications, and your prescription distance glasses (bifocals) and/or reading glasses with you to your appointment.

Please bring the completed forms, along with your current insurance card(s), a photo I.D. or Driver’s license, list of medications, and your prescription distance glasses (bifocals) and/or reading glasses with you to your appointment.

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Patient Forms
Formas An Espanol
Privacy Practices