Patient Information Form
If you are new to the office or have moved, changed insurance, etc. Please print and complete this form and bring with you to your appointment. Otherwise, you can complete the forms at the office.
Health and Vision History Form
If you have new symptoms, or are a new friend to TMS Eyecare, please print and complete this for your office visit.
Release of Health/Vision Records
Authorization for Release of Identifying Health Information.
Download, print and complete this form if you need records sent to us from other doctors or from us to them, also to allow other individuals that you specify access to your health information.
Acknowledgement of Notice of Privacy Practices
Our Notice of Privacy Practices is available to view via a link at the bottom left corner each page of this site, (where all the legal stuff typically goes) or we’ve got lots of copies at the office. Whether you actually read it or not we need your signature on this form to show you’ve been given access to it. Thanks a bunch for helping us comply with the law.
Under this program, participating optometrists provide a comprehensive infant eye assessment between 6 and 12 months of age as a no-cost public service. Even if no eye or vision problems are apparent. For more information read, “Your Infant’s Vision.”