Patient Forms
We want your appointment with us to be as
smooth, efficient, and comfortable as possible.
Introducing, IntakeQ.
A secure and simple way to exchange information.
We are excited to offer you the ability to complete your intake process privately and conveniently prior to your appointment. A pre-visit email will be sent to you, providing you with a private way to give your doctor all the information she needs for your upcoming visit, and saving you time in the waiting room.
Notice of Privacy PracticesNLOAD DOCUMENT
Every text, image, icon or button can be edited or replaced simply by selecting it and applying any customisation.
Registration FormLOAD DOCUMENT
This is a front-end page builder where what you see is what you get. We designed it so you can be in complete control.
Office Policies Form
No matter if you've used a visual page builder before, with this you'll be a pro the second you start using it.
Financial Waiver Form
The bread & butter of our platform are the pre-built design sections, called items that you can add to the page.
Contact Lens Policy & Professional Fees Form
Just click & drag to create beautiful pages in a matter of minutes. No designer talent or coding skills necessary.
Consent to Examine Minors
If your child is a minor and is coming to the office without a legal guardian, a consent form must be signed in order for your child to have an eye exam and receive treatment. Please send in the XX Form with your child.
COVID-19 Consent Form
The bread & butter of our platform are the pre-built design sections, called items that you can add to the page.
Medical Release Form
Just click & drag to create beautiful pages in a matter of minutes. No designer talent or coding skills necessary.
Request Your Appointment Today!
If you’d like to find out more about our practice or would like to schedule an appointment
with B-Town Eyecare, we invite you to give us a call today at 206.242.8545 or,
REQUEST APPOINTMENT
Request Appointment
Please provide the details below and we will do our best to accommodate your request.
Visit Us
Our Culture & Core Values
Innovation | Collaboration
Respect
Authenticity | Gratitude
Hours
Monday | 9:00 - 5:30pm |
Tuesday | 9:00 - 5:30pm |
Wednesday | 9:00 - 5:30pm |
Thursday | 9:00 - 5:30pm |
Friday | 9:00 - 3:00pm |
