Online Patient Forms

At SightMD Connecticut, 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.

New Patient Information Form – Required

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 & Print Form

Medical History Form

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 & Print Form

Permission To Accompany A Minor

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 & Print Form

Records Release Authorization

The medical record information release (HIPAA) form lets a patient allow any person or 3rd party to have access to their health records.

Download & Print Form

Financial Policy

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 & Print Form

Make an Appointment

Contact our team to book your appointment and find out what treatment plan is best for you.

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Related Locations

  • Hartford
    Hartford

    860-560-9563

    1500 Albany Avenue
    Hartford, CT 06112

  • Manchester
    Manchester

    877-342-4626

    178 Hartford Road
    Manchester, CT 06040

  • New Britain
    New Britain

    860-357-2349

    1232 Corbin Avenue
    New Britain, CT 06053

  • Torrington
    Torrington

    860-489-8999

    1144 E Main Street
    Torrington, CT 06790