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Patient Forms Patient History Check In Forms Notice of Privacy Practices Screening Tests Records Release Authorization

 

 

 

 

PATIENT FORM LINKS

   

New Patients: 

Please complete the 4 forms listed to the left 1 week prior to your appointment. 

PLEASE READ

  

Your history forms are an important part of the vision and health exams you receive from our office. The information allows Dr. Valella  to evaluate your vision system and how it relates to your health and lifestyle. Thoroughness relies on your compliance in answering all questions.

 

  

Please remember to bring both your vision and health insurance cards, glasses and contact lenses.

 

Payment is due when services are rendered.

  

  

 We look forward to "seeing" you.

 

 

 

 
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