Patient Forms
NEW PATIENTS FILLABLE FORMS (MUST DOWNLOAD & SAVE all forms first before filling them out)
1. Please fill out all three forms below and email completed forms to eyesplusinc@gmail.com before your scheduled appointment.
2. Please bring a valid picture ID (ie, drivers license, state ID)
3. Please also bring all your current insurance card and/or information (ie, Insurance name, member ID #, plan type)
1. Please fill out all three forms below and email completed forms to eyesplusinc@gmail.com before your scheduled appointment.
2. Please bring a valid picture ID (ie, drivers license, state ID)
3. Please also bring all your current insurance card and/or information (ie, Insurance name, member ID #, plan type)
| PATIENT INFORMATION |
| PATIENT ACKN. & OFFICE POLICIES |
| NOTICE OF PRIVACY PRACTICES |
RETURNING PATIENTS
1. Please bring all your current insurance card and/or information (ie, Insurance name, member ID #, plan type) if anything has changed.
2. If you have not seen Dr. Makini for over 3 years, Paperwork will be required to be completed and submitted to our office prior to your appointment to update your file.
1. Please bring all your current insurance card and/or information (ie, Insurance name, member ID #, plan type) if anything has changed.
2. If you have not seen Dr. Makini for over 3 years, Paperwork will be required to be completed and submitted to our office prior to your appointment to update your file.
