All patients, please review the following forms before your initial appointment:
- Financial Responsibilities
- Use and Disclosure of Protected Health Information
- Signature on File, Assignment of Benefits, Financial Agreement
Laser vision correction patients, please review the following forms before your initial evaluation:
Consent forms for surgery:
Post-operative instructions for surgery:
- Corneal Abrasion and Erosion
- Corneal Disease and Corneal Transplants
- Corneal Ulcer
- Fuchs Corneal Dystrophy
- Herpes Simplex Eye Disease
- Herpes Zoster
Medical Records Requests
To obtain a copy of your medical records*, please download the following release form for the correct location.
The form may be sent via e-mail or fax to:
Fax: (240) 482-3070
Fax: (301) 215-4144
Fax: (202) 452-1415
Fax: (703) 883-0222
*There will be a charge for a copy of your medical record – refer to the form for pricing.
Please allow two weeks time for processing.