HELPFUL APPOINTMENT INFORMATION & FORMS

Call now for an appointment​
with one of our board certified providers :
(814) 237-4105

Call now for an appointment 
with one of our optical services experts :
(814) 238-5392

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PRINTABLE FORMS:

PERSONAL INFORMATION FORM

MEDICAL RECORDS REQUEST & AUTH FORM

PATIENT HISTORY FORM

PHI DISCLOSURE AUTHORIZATION

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ITEMS TO BRING TO YOUR APPOINTMENT:

• Completed forms from above if you are a new patient or any information has recently changed
• Vision & Medical Insurance Card(s)
• Referral from your primary care physician if required by your insurance company
• A list of current medications - including the dosage and frequency
• Current glasses
• Contact lens information (boxes from current or old lenses are best)
• Payment/Copayment
  • We accept cash, check, and credit cards (Visa, Mastercard, Discover)
  • We are also able to accept Apple Pay/Tap as long is it is linked with one of the above credit cards
• Assistance getting home, if needed, as you may be dilated