Do the paperwork at your kitchen table, not our waiting room.
Everything we need from you can be completed before you arrive. It takes about ten minutes at home, and it takes about thirty in a waiting room with a clipboard and a pen that does not work.
Complete everything in our patient portal.
Open the portal on a phone, tablet or computer, answer the questions, and you are finished. Nothing to print, and nothing to remember on the day.
Your answers go straight into your chart, which means we have read them before you sit down — and the visit starts with your eyes rather than your address.
First time here? You will receive an invitation to set up your portal account when you book. If you cannot find it, call the office and we will resend it — or complete the printed forms below instead.
To wire up: replace [[EMA PORTAL URL]] with our ModMed EMA patient portal address. Do not build a separate website form — anything collecting patient information must stay inside EMA, which is already covered by our business associate agreement.
Prefer paper? That is completely fine.
Download, fill them in at home, and bring them with you. Take your time and check your medication list against the bottles in your cabinet — that is the part everyone guesses at.
Everyone, every visit
- Patient registration — name, contact details, emergency contact, pharmacy
- Insurance information — plan, member ID, and any secondary coverage
- Medical and eye history — conditions, surgeries, allergies, family eye history
- Current medications — everything, including eye drops and over-the-counter products
New patients, once
- Notice of Privacy Practices acknowledgment
- Consent to treat and assignment of benefits
- Financial policy
- Communication preferences — how we may contact you, and who we may speak with about your care
- Authorization to release records, if you are transferring from another practice
Before surgery
- Surgical history and medical clearance
- Anesthesia questionnaire
- Lens selection worksheet — questions about how you actually spend your days, which is what determines the right lens
For specific visits
- Cataract evaluation questionnaire — night driving, reading, sport, glare
- LASIK candidacy questionnaire — contact lens history and prescription stability
- Dry eye questionnaire
- Oculofacial consultation form
To be produced: each form above needs a downloadable PDF, reviewed by the practice and by counsel before publication. The list is a proposed set — the billing office and the surgical coordinator should confirm it matches what we actually collect.
What to bring, even if you completed everything online.
- Your insurance card and a photo ID
- Your glasses, and your contact lens boxes if you wear them
- A list of your medications, or the bottles themselves
- Sunglasses — if we dilate you, you will want them for the drive home
- Anyone who helps you keep track of things, if that is useful to you
If you wear contact lenses and you are coming for a surgical evaluation, call us first. There is a period you need to leave them out beforehand, and it changes your measurements.
Ten minutes now, or thirty in the waiting room.
Complete your forms in the patient portal before you arrive, or print them and bring them with you.