Patient Forms

A SECURE AND SIMPLE WAY TO EXCHANGE INFORMATION

Thank you for filling out the forms before your visit. Its saves you time and helps us keep on schedule. Please review the Notice of Privacy Practices and fill out three forms: Registration Form, Acknowledgement of Receipt of Privacy Practices, and the Financial Waiver if you’re planning to use insurance or a vision plan.

Notice of Privacy Practices

Financial Waiver

Registration Form

B-Town Eyecare Policies

Policies for Eyeglasses and Contacts

Advanced Beneficiary Notice

Contact Lens Policies and Professional Fees

Medical Records Release

Acknowledgement of Receipt of Privacy Practices