Now Accepting Digital Patient Forms
At SightMD New York, we value your time. You can now fill out and submit your patient forms online prior to arriving for your appointment!
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Downloadable Forms
If you prefer to have hard copies of these forms for your records please select from the list below.
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.
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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.
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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.
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