New Patient Forms

If you are a new patient at Moore Eye Institute and have scheduled an appointment, you may print and complete the following forms, then bring them to your appointment.

New Patient Information (PDF)
Health History (PDF)
Patient Demographics
Hippa Privacy Act

Things to Remember for your Appointment:

• Parents must accompany children under the age of 18 in order to complete and sign the necessary paperwork.
• Arrive 10-15 minutes early to allow time for the check-in process.
• Bring the following items with you:
  • Photo Identification
  • Insurance Card (medical and vision, if applicable)
  • Any relevant medical records for existing conditions related to eye care
  • Previous eye exams from your last doctor, if you have them
  • Contact Lens wearers: please bring your most recent prescription and /or contact lens box
• Please note: Though we try to adhere to your scheduled appointment time, emergency "work-ins" or unforeseen problems may occur and cause your doctor to run behind schedule. If the front desk is aware of any such circumstances, you will be notified at the appropriate time.

For more information on Finance & Billing, including an estimation of fees for basic services, click here.

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