Online Patient Forms
At SightMD, 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.
- 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.
Please complete this form as it lets us know your basic personal and insurance information as well as who to contact in the event of an emergency.
Download New Patient Information Form for Connecticut
Download New Patient Information Form for New Jersey
Please complete this form as it lets us know your basic Medical History information as well as any existing eye problems, previous surgeries, medications you are taking or allergies you may have.
Download Medical History Form for Connecticut
Download Medical History Form for New Jersey
By law, any child under the age of 18 years old cannot be seen by a doctor without written consent from a parent or without an adult present. If the minor is under 16, he/she must be accompanied by an adult. If the minor arrives with someone other than a parent or legal guardian, we must have written permission from the parent or legal guardian that this person has been appointed by you to act on your behalf.
Download Permission to Accompany a Minor Form for Connecticut
Download Permission to Accompany a Minor Form for New Jersey
Download Permission to Accompany a Minor Form for New York
Download Permission to Accompany a Minor Form for Pennsylvania
The medical record information release (HIPAA) form lets a patient allow any person or 3rd party to have access to their health records.
Download Records Release Authorization Form for Connecticut
Download Records Release Authorization Form for New Jersey
Download Records Release Authorization Form for New York
Download Records Release Authorization Form for Pennsylvania
At SightMD, we are dedicated to providing the best possible care and service to you. We regard your complete understanding of your financial responsibilities as an essential element of your care and treatment. In order to reduce confusion and misunderstanding between our patients and the practice, we have adopted the following financial policy. Unless other arrangements have been made in advance by either yourself or your insurance plan, full payment is due at the time of service.
Download Financial Policy Form for Connecticut
Download Financial Policy Form for New Jersey
Attention New York!
We are now accepting digital patients forms for all of our New York patients. You can fill our and submit your patient forms online prior to arriving for your appointment.
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