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Online Forms

At Regional Eye Center, 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 AdobeReaderĀ® 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.
  • For an appointment you need ONLY 3 FORMS: Patient Information, Consent for Pupil Dilation and Protected Health Information and Contact Lens Fee Agreement.

Patient Information

Download & Print Form

Request Release of Medical Records Form

Download & Print Form

HIPAA Privacy Policies

Download & Print Form

Contact Lens Fee Agreement 

Download & Print Form 

Consent for Pupil Dilation And Patient Protected Health Information

Download & Print Form


Download the Free AdobeReaderĀ®

Hours of Operation

Our Regular Schedule

Regional Eye Center

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

7:00 am-4:30 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-2:00 pm

Saturday:

Closed

Sunday:

Closed

Location

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