Forms for Clinic Patient
Complete Package: Click Here to Download the Complete Patient Form PackageIndividual 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
Forms for Surgery Patient
Complete Surgery Center Package: Click here to Download the Complete Surgery Center Form Package that will need to be completed by surgery center patients.
Individual Surgery Center Forms
- Medical Clearance
- Pre-Anesthesia Questionnaire
- Patient Acknowledgement
- Surgical Patient's Rights
- GA Advanced Directive for Health Care
- EPS Surgical Request for Release of Medical Info
- EPS Surgical Notice of Privacy Practices
- Medicare & Glasses After Cataract Surgery