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.

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

Use our online scheduling tool to book your appointment and find out what treatment plan is best for you.

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Related Locations

  • Amityville
    Amityville

    631-608-1542

    805 Broadway
    Suite 106
    Amityville, NY 11701

  • Babylon
    Babylon

    631-957-3355

    500 West Main Street
    Suite 210
    Babylon, NY 11702

  • Bay Shore
    Bay Shore

    631-665-1330

    375 E. Main Street
    Suite 24
    Bay Shore, NY 11706

  • Bay Shore - Pediatrics
    Bay Shore - Pediatrics

    631-665-3918

    180 E. Main Street
    Bay Shore, NY 11706