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Patient Forms

Below are patient forms for your upcoming visit with Ophthalmology Associates. If you are a NEW PATIENT you can complete the Patient Registration Forms online by clicking the button below.

If you are an ESTABLISHED PATIENT and have seen us before, these forms only need to be completed once per year UNLESS, you have moved, changed insurance or have had changes in your medications or medical history that need updating.  You can complete these forms online by clicking the blue button below.

Patient Registration Form (English)Patient Registration Form (Espanol)

If you prefer to print the registration forms and bring them with you on your visit, please print the HIPAA, Patient Financial Agreement and Medical History forms and have those completed when you arrive.

HIPAA and PRIVACY NOTICE ACKNOWLEDGEMENT ENGLISH VERSION

HIPAA AND PRIVACY NOTICE ACKNOWLEDGEMENT SPANISH VERSION

PATIENT FINANCIAL AGREEMENT 2019 ENGLISH

PATIENT FINANCIAL AGREEMENT 2019 SPANISH

Medical History Form

Medical History Form SPANISH

Below are additional patient forms that you can print if you have a need for them.

Medical Records Release Form NEW INCOMING

Medical Records Release Form NEW OUTGOING

Notice of Privacy Practices English

Notice of Privacy Practices Spanish

Notice of Privacy Practices English and Spanish Combined

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