Patient Forms and Resources
Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.
New patient packet to acquire new patient information and medical history
Release of patient health history from Heart of America Eye Care, P.A.
Release of patient health history to Heart of America Eye Care, P.A.
We strive to provide you the very best care. In order to do so, we would like to acquaint you with our office policies. Please read this over carefully. We also suggest you review your health insurance policy and familiarize yourself with the coverage it provides.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
*Individual results are not guaranteed and may vary from person to person. Images may contain models.