At Eye Florida, we value your time. In an effort to save you time in our office and make your experience as pleasant as possible, you can download and complete our patient forms prior to your appointment.

NEW PATIENT FORMS

PATIENT INFORMATION SHEET (REQUIRED)

Help us understand your history and the current state of your health, as well as what questions, concerns, and goals your have about your eye health or vision.

PRE-VISIT INSTRUCTIONS FOR ROUTINE EYE EXAM POLICY

MEDICAL RELEASE FORM

INSTRUCTIONS FOR YOUR EYE LASER PROCEDURES

HOW TO PUT IN EYE DROPS

Leer en Español: Cómo utilizar las gotas para los ojos

EYE FLORIDA REFRACTION FEE NOTICE FOR PATIENTS

As of January 4th, 2021

There are two parts to your MEDICAL EYE examination, which are billed separately.

The first charge includes the fee for the doctor to evaluate the health of your eyes. This charge is billable to your medical insurance company, and also to Medicare.

The second (vision) portion of your exam is called a “refraction,” which is a test performed to determine the best corrective lenses to be prescribed for each eye.

Although a refraction (CPT 92015) is a very important vision test, it is considered a non-medical procedure. Medicare and most medical insurance plans do not pay for this service, the fee of which is now $35.00.

We request that payment for this service be made prior to getting your test (refraction) to update your glasses prescription. Thank you.