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| Your Eye Care Team |
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We look forward to seeing you.
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Please click on the links below
to download patient forms.
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The Appointment information and office map form is general information regarding your appointment.
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The Patient Information Form is to be completed and brought to your appointment.
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The Health History Form is to be completed and brought to your appointment.
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The Financial/Privacy Practices form is to be completed and brought to your appointment.
A copy of the Noticy of Privacy Practices will be available at your appointment
or can be obtained by calling 823-4441.
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The Records Release can be sent to your previous doctor's office if necessary.
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This is the history form for InfantSEE assessments only.
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If you have difficulty downloading these forms,
please contact our office at 434.823.4441.
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