For new patients who would like to book an appointment, please return the requested information below via email to email@example.com.
You will also find our safety protocols below. Before we book you an appointment, we must have these forms filled out and returned. Receipt of your forms will be taken as acceptance of our new policies, described below.
Be aware of your insurance coverage beforehand. We are unable to look into your benefits. We must have your completed Insurance Authorization Form in the system prior to your appointment to be able to bill your insurance electronically.
Reminder, please check all boxes and sign all forms.
Please be aware of the protocols below prior to emailing your paperwork.
Once these are all received and added into our system, we will contact you for an appointment.
Our appointment times are more precious than ever given the current restrictions. If you are running late, we may not be able to accommodate your appointment. Our doors remain locked at all times. Patients arriving for their appointment should call our office upon arrival, where we will take a verbal case history and ask relevant questions prior to unlocking the door.
Please notify our office at least 24 hours prior to your appointment. Failure to do so will result in a charge of $50. Future appointments will only be fulfilled after the balance is paid in full.
Masks must be worn at all times in the office for anyone over the age of 2. Masks must cover both nose and mouth simultaneously for the entire time you are in the office. Please bring your own mask if you have one. If you do not, we have some masks available for which we are asking a $2 donation (donations going to Optometry Giving Sight). PPE is difficult to come across, so again, if you have your own, please wear it.
If you cannot or will not wear a mask, please do not book an appointment - you will not be seen without a mask. If this is an issue, we recommend waiting until masks are no longer required to book an appointment.
Hand sanitizer must be used at the entrance and exit of the office - we have some just inside our front door.
Please note that only one patient is allowed in the office at a time. Children may be accompanied by one adult. No more than two children in the office at a time.
Read our full list of policies.
We look forward to hearing from you.