Online Forms

Portland Eye Care Online Forms

Routine vision exams will be billed to a patient’s vision insurance plan if one is available and we are in-network. A routine exam means that there is no medical diagnosis present and a vision diagnosis is primary (myopia, hyperopia, astigmatism, and presbyopia). If a medical diagnosis such as cataracts, diabetes, glaucoma suspect, foreign body, dry eye, etc. is determined by the doctor, the exam is no longer routine and it must be submitted medically. In this situation, the exam will be billed to all medical insurances that the patient provides and then coordinated to vision if your plan allows it. Our exams cover all aspects of your vision and eye health, so you can trust the doctor and staff at Portland Eye Care.


Patient Forms

Please print the first three forms below and fill them out prior to your scheduled appointment. The last form is for review only (no signature is required).

PDF File
Intake Form
PDF File
Health History Form
PDF File
Financial Policy Form
PDF File
HIPAA Policy Review
 
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All Eye Care Services

Find personalized eye care excellence with our comprehensive services. From eye exams to advanced diagnostics, trust us for all your vision needs.

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For non-urgent questions or to learn more about our services, contact us today!