Eye Exams, Contact Lenses, Eye Glasses

(954) 961-2200

6850 Miramar Parkway
Miramar, Florida 33023

Contact Us

Office Forms

Here you will find all the forms that you will be given if you are a first time patient to our office or if you need to update any contact
information.

The Patient Intake Form and HIPPA Privacy Agreement can be
printed out and filled out and brought with you on the day of your visit. This will
help both you and us in shortening the time that you will spend before seeing
the doctor.

The HIPPA Privacy Act is the available in both English and Spanish. This form will explain all the rights that you have as a patient.

These files require the free Adobe Acrobat Reader Note: Adobe Acrobat Reader is required to view the files listed below.
Download the free Adobe Acrobat Reader now.

Download Forms: English

Download Forms: Español