Welcome to our practice! The following documents are a prerequisite for all new patient appointments according to your personal specifications to complete the registration process. Please arrive to your appointment about 10 minutes before your designated time and bring these documents with you completed as well as photo I.D., insurance card, a list of any medications and prescription glasses. If a referral is needed by your insurance company, it is your responsibility to obtain beforehand. A co-payment may be required and will also be collected at the time of check in as this is your insurance contract. All new patient and cataract appointments expect your eyes to be dilated so they will be sensitive to light. Please call the office if you have any questions regarding these documents at (508) 226-1809.
Thank you for assisting with expediting your visit to Attleboro Ophthalmological Assc., Inc.
New Patient Forms:
- Notice of Privacy Practices
- Privacy Practice Acknowledgement
- Demographic Form
- Financial Policy
- Financial Policy Acknowledgement
- Medical Questionnaire
- Medical Records Release
Additional Form for Medicare Patients:
Cataract Patient Forms:
- Complete all above forms before moving on to the following two forms
- Pre-Cataract Surgery Questionnaire
- Lens Questionnaire
