For your convenience, we have made a number of forms available for patients to download. If you are new to our practice, we encourage you to download and print out the new patient forms. Filling these out in advance of your first visit will minimize the time you spend in the waiting room filling them out when you get here. Other forms are informational. If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you’re not sure which forms you need, please call 610-687-6888 for assistance.
Cosmetic Patients
Patient Information
Medical History Questionnaire
Cosmetic Questionnaire
Ptosis Questionnaire
HIPPA Form
Payment & Insurance Information
Cataract Patients
Patient Information
Medical History Questionnaire
Visual Assessment to Determine Medical Necessity
Vision Preferences Checklist
HIPPA Form
Payment & Insurance Information
General Patients
Patient Information
Medical History Questionnaire
HIPPA Form
Payment & Insurance Information
Physician Consult
For Doctors Only: Consultation/Referring Doctor Form
If you’re unable to open these files, you probably need to download the free Adobe Acrobat Reader program, which is available at the following location: www.adobe.com/products/acrobat/readstep.html
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