As a new patient to our practice, we would like to offer a warm welcome and our thanks for choosing us to provide your eye health and vision care. In order for us to establish your file, and provide the utmost beneficial use of your time with us, the doctor has asked you to complete the following tasks and bring the results to your appointment. The doctor needs this information in order to give you the best care possible.
This diagnostic information includes personal and family information needed to establish your file, as well as your current eye health and vision status. Your responses will guide our doctors and staff, and remind us to address any significant issues during your visit.
Since many general health conditions may be associated with visual symptoms and/or eye health problems, this important record (now required by state health boards and virtually any medical and optical insurance plans) will allow us to care for you as a “whole person” rather than just a pair of eyes. This form includes a complete list of prescription and non-prescription medication, which may be brought in as a separate list for us to photocopy if you prefer.
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For any optical and/or medical insurance you may be covered by. (Even for “routine” visits, if a medical eye condition is discovered during your examination we can submit a claim to your health insurance for the medical evaluation portion of your examination.) According to the FTC’s Red Flag Rules, #183 16 CFR Part 681, medical practices must do their part in reducing identity fraud by positively ID’ing patients to match them to the covered member on their insurance card.
Please bring ALL pairs of eyeglasses your currently use, including prescription or non-prescription reading glasses, sunglasses, etc. We have instruments to compare the optical power of your old lenses with your new exam findings, thus enabling us to determine and explain how your vision has changed over time. We can also evaluate the condition and fit of your current eyewear.
It is best to wear your current contacts to your appointment if possible. Next best is to bring them along in your case. If you wear planned replacement or disposable lenses, it is very helpful if you bring along your cartons or lens packets that indicate the lens series, power, manufacture, etc.
Please place any eye drops or ointments that you use in a small bag and bring it along with you. Your doctor will review whether these are appropriate or if a better option is available.
With advancing examination techniques and technology dilation with drops is not always necessary. But if necessary the doctor may use drops to dilate your eyes in order to fully evaluate their internal health. This has the effect of temporarily increasing sensitivity to light and causing “fuzzy” vision at a near (reading) distance. This effect can last 4-6 hours. You may want to come early to look at our frame selection. We can give you disposable sunglasses to take with you if you forget your own sunglasses to help with the post dilation light sensitivity.
Completing the task list for the items that apply to you will assure you of receiving the most thorough and professional care possible and in a very efficient manner.
We look forward to your visit!
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