0% FINANCING FOR 12 MONTHS
Please click here to see our general patient information form. This is basic information about you and your health including eye conditions.
Please click on on the picture and then "Open" in the appearing window.
This is the information we use to file insurance claims on your behalf. Please complete this form and return to us so that we can process the insurance payment information.
By law, we are required to keep your information confidential. Please rest assured that we fully respect patient privacy and rights.
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