At Fishkind, Bakewell, Maltzman & Hunter Eye Care and Surgery 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.
In addition to eye care, we offer an online, HIPAA-compliant Patient Portal, which provides free, secure access to all your important health information. There, you can view chart records, medication prescriptions and refills, and more. It is also easier than ever to send questions through email or request appointments, as well as make online payments without picking up the phone. Preexisting patients can easily register for the portal. If you are not yet a patient with us, we will help you sign up when we see you.
Patient Registration, History & Medications Forms
These forms should be completed by all new patients, and by established patients coming for annual comprehensive examinations.
Use this form to help monitor your vision if you have macular degeneration, or other macular disorders.
Authorization for Release of Medical Records
This form should be completed to provide authorization to release your medical records.
- 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.