We participate with VSP, Medicare, Medicaid and EyeMed. Check with our staff if you have other types of coverage.
Receipt of HIPAA Documents
This form is a required acknowledgement by a patient (or personal representative) that the HIPAA Notice of Privacy Practices has been presented. It must be kept on file for all patients.
Patient History Form
This is a form that you can fill out prior to your appointment. This form provides information that is necessary for multiple aspects of your visit to PersonalEYES Vision Care. This is used to enter your personal information correctly in our computer system, to help confirm and bill your insurance, and to help our doctors with personal and medical history. Thank you for taking the time to complete this form.
Records Release / Request Form
This form is required if you desire to have the records from your previous doctor sent to our office, or if you are requesting us to send your records elsewhere.