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New Patients

Click on the links below to access our Medical Questionnaire and HIPAA Acknowledgement forms. Please complete these forms and bring them, and your most current insurance card, to your scheduled appointment.

Medical  Questionnaire

Medical Questionnaire

This form helps us gather information about you that will help the doctor understand your past and current state of health.
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HIPAA Acknowledgement

This form is a signed agreement of Perspective Eye Care’s Privacy practices as it relates to your medical and personal information.
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HIPAA Acknowledgement