Patient Forms

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For new patients, please select the "Welcome to Our Office" form
which can be printed and filled out before coming to the office.
For established patients please select "Welcome Back to Our Office Form" which can be printed and filled out before coming to the office.
All patients need to read and sign the HIPPAA or Privacy Agreement. Please print and sign this form before your visit.
If your office visit involves insurance or a vision plan, please also fill out the "Insurance Office Form" prior to your visit.

Welcome to our office Family Eyecare (New Patients Only)

Healthy Testing Necessary for Proper Patient Care

Notice of privacy practices (HIPPA)

Insurance Office Form

Patient Record Release Form

Welcome back to our office form (Established Patients Only)

We ask that you either fax or phone in your insurance information to us so we can get a head start on the verification and eligibility process. If this is done a day or two prior to your arrival, this will decrease your time in the office dramatically.

Thank You, Family Eyecare of Roswell