At Avery Eye Clinic, we value your time. In an effort to save you time in our office, we ask that you download and complete our patient forms prior to your appointment.
- You will need AdobeReader® to view and download the forms.
- Download the required forms. Print out the forms and complete the required information.
- Fax your printed and completed forms to our office or bring them with you to your appointment.
Welcome Letter
Download & Print Form - English
Download & Print Form - Spanish
New Patient Welcome Packet
Download & Print Form - English
Download & Print Form - Spanish
Established Patient Packet
Download & Print Form - English
Download & Print Form - Spanish
Patient Demographics
Download & Print Form - English
Download & Print Form - Spanish
Financial Policy
Download & Print Form - English
Download & Print Form - Spanish
Refraction ABN
Download & Print Form - English
Download & Print Form - Spanish
Medical History
Download & Print Form - English
Notice of Privacy Practices
Download & Print Form - English
Download & Print Form - Spanish
Notice of Privacy Practices Acknowledgement
Download & Print Form - English
Download & Print Form - Spanish