New Patient Forms


To Save Time, Please Print All Forms, Fill Out and Bring To Your Appointment.


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New Patient Form
New Patient Demographic and Medical Health Information
New Patient form.pdf
Adobe Acrobat Document 162.0 KB
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Eidon-Optovue Testing Consent Form
Retinal Imaging and OCT testing consent
Eidon-Optovue Testing consent.pdf
Adobe Acrobat Document 480.8 KB
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HIPAA
HIPAA Disclosure Form for Five Forks Family Eye Care
HIPAA.pdf
Adobe Acrobat Document 87.6 KB
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Notice of Privacy Practices
Notice of HIPAA Privacy Practices
2014 Notice of Privacy Practices.pdf
Adobe Acrobat Document 112.9 KB