At Sound Vision Care, Inc., we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
- You will need AdobeReader® to download and complete the forms. Click here to download.
- Download the required form(s). Print out the form(s) and complete the required information.
- Fax your printed and completed form(s) to our office or bring them with you to your appointment.
Patient History Form - English
To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year.
Patient History Form - English ( click to view )
Patient History Form - Spanish
To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year.
Para ser completado por todos los nuevos pacientes y cualquier paciente que no ha tenido una cita en un año o año calendario.
Patient History Form - Spanish ( click to view )
Patient Letter
Patient Letter ( click to view )
Patient Advance Beneficiary Notice of Non Coverage (ABN) - English
To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year. To be completed also by any patient who has had a change in insurance or benefits.
Patient ABN Form - English ( click to view )
Patient Advance Beneficiary Notice of Non Coverage (ABN) - Spanish
To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year. To be completed also by any patient who has had a change in insurance or benefits.
Para ser completado por todos los nuevos pacientes y cualquier paciente que no ha tenido una cita en un año o año calendario. Para ser completado también por cualquier paciente que ha tenido un cambio en el seguro o beneficios.
Patient ABN Form - Spanish ( click to view )
Contact Lens Agreement
For any patient wishing to have a Contact Lens Exam - To be completed each year.
Contact Lens Agreement ( click to view )
Gentle Vision Shaping System Agreement
For any patient in need of a Gentle Vision Shaping Exam - To be completed each year.
Gentle Vision Shaping System Agreement ( click to view )
Amsler Home Test
For any patient with a Macular Condition to monitor their central vision.
Amsler Home Test ( click to view )
Notice of Privacy Practices
Notice of Privacy Practices ( click to view )