Somers Eye Center - Forms
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BEFORE YOUR VISIT

It is our goal to make your visit as pleasant and convenient as possible. Please take a minute to download and fill out the patient forms below to minimize wait time in the office.

Please arrive 15 minutes before your scheduled appointment time. A comprehensive eye examination will last approximately one to one and a half hours. In order to check the overall health of the eye, dilation drops may be used. This can result in difficulty reading and sensitivity to sunlight following the exam.

Please bring the following:
  1. Current insurance card
  2. Glasses, sunglasses (if prescription) and original contact lens containers if available
  3. Any eye drops you are using
  4. A list of all prescription medication you take
  1. PARENT INFORMATION FOR PATIENTS UNDER 18 YEARS OF AGE
  2. PATIENT INFORMATION FORM
  3. HIPAA
  4. PATIENT HEALTH HISTORY
  5. PRIVACY PRACTICES
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