Patient Forms & Policies
The Eye Center of North Florida is committed to providing you with outstanding care. Here you will find useful information about your rights and responsibilities as a patient, policies and other important patient information. If you have questions, please do not hesitate to contact us at (850) 784-3937.
New Patient Information
You can save time during their first appointment by completing the Patient Registration form prior to your first visit. Simply print out the Patient Registration form, fill in the information requested, and bring the completed forms with you to your appointment. Please do not bring in completed paperwork early or mail into the office- we ask that you just bring it with you at the time of your scheduled appointment. Please note, for cataract evaluations and other specialty appointments you may have additional paperwork to complete.
Authorization to Transfer Records
You may choose to transfer your medical records from your previous eye care provider to The Eye Center of North Florida. Download and complete the form which authorizes your previous provider to release your medical records to The Eye Center. This form does not need to be completed unless you need us to request records from a previous provider.
Policies & Notices
- Notice of Privacy Practices
- 21st Century Cures Act: No Information Blocking
- Notice to Patients- Corporate Relationships
- Notice of Non-Discrimination — download information
- Multi-Language Notice of Interpreter Services– download information
These forms are in Adobe Reader PDF format and require that you have Adobe Reader installed, which can be downloaded for free. Click here to download Adobe Reader.