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Patient Forms

Patient forms to be completed before your next visit to Accurate Vision Clinic.

Our forms for NEW patients to bring to your exam, please fill out BOTH pages.
Patient Welcome Form [PDF]
Insurance, Billing, & Privacy
Explanation of insurance, billing policies, and privacy for ALL patients.
AVC Patient Financial and Billing Policy [PDF], please read and sign
AVC Privacy and Communication [PDF], please read and sign
AVC Notice of Privacy Practices [PDF], please read both pages

Record Release Form
This form is to be filled out if you would like us to request records from your previous eye doctor. Or if you would like us to provide you with a copy of your records from Accurate Vision Clinic.

AVC Records Release [PDF]

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