Patient Forms

Your First Appointment at Sneed Eye Associates

In preparation for your first appointment, you will complete certain forms. These forms provide us with valuable information about your medical needs and help us accurately handle your records. You can fill these forms out during your visit or, to save time, you can print these files, fill them in, and bring them with you to your appointment. Please remember to bring insurance and/or Medicare cards. Please call us with any questions.

• Patient Registration and Insurance Record
  
• Medical History Questionnaire
  
• Refraction Service and Fee
• Consent for Release of Protected Health Information
  
• Privacy Practices Notice Receipt & Authorization for Release of Medical or Financial Information & Cell Phone Policy Acknowledgement