Forms for Clinic Patient

Complete Package
Click Here to Download the Complete Patient Form Package

Individual Forms for Download

• Authorization For Release of Records to EPS
• Authorization for Release of Medical Information
• Financial Policy
• GA Patient’s Right to Know
• List of Medications
• Medical vs. Vision Insurance
• Medical History Questionnaire
• Medicare & Glasses After Cataract Surgery
• Notice of Privacy Practices
• Patient Information Form
• Patient Acknowledgement Form
• Refraction Service & Fee