New Patients & Forms
Printable Form for First VisitWe provide a child friendly environment for both the waiting room and the examination itself. We work with your primary care doctor to keep him or her informed as to your child’s condition.
Please bring in proper referrals, insurance cards and appropriate co-pays (check with your insurance company if unsure). Many insurance companies do not allow us to examine your child without a proper referral. This is the patient’s responsibility and the office is usually unable to facilitate this for you on the day of the exam. On the day of the exam, if proper referrals have not been made, appointments may have to be re-scheduled along with a $25.00 missed appointment fee.
We participate with many insurance programs, we do not participate with any vision plan. Prior to your visit, it is your responsibility to inquire about the need for a referral and the amount of your co-pay. Many plans, including all HMO plans, require a referral for each visit. We regret that we will be unable to see patients without the appropriate referrals.
Your doctor likely has referred you for a medical eye evaluation and this will be billed under you medical insurance (not your “vision plan”- WE DO NOT PARTICIPATE WITH ANY VISION PLAN) so make sure you have the appropriate medical referral or authorization ahead of time.
Co-payments should be made prior to service. There is a $25 fee for returned checks.
You should allow two hours for the initial complete exam. This includes time waiting for the eye dilation drops to work (usually 30-45 minutes). The eye drops used are designed for children/infants and will be uncomfortable for about a minute. As the drops begin to work, your child will have trouble seeing things up close for a few hours. The effects of the drops wear off in a few hours; however, the black pupils may remain large and sometimes unequal for a few days. There is no need to warn the child ahead of time about the drops since the anticipation may be worse than the drops themselves.
Your child’s vision will be carefully checked. Click here if your child does not comfortably know his/her alphabet. Attention will be directed to the problem or concern; however, a complete exam is usually performed. This includes testing the eye muscle balance and stereopsis/ depth perception, color vision testing in boys, and examination of the outer and inner eye structures. Glasses are prescribed when indicated.
The prescription for glasses in young children is based on neutralizing a reflex off of the back of the child’s eye using different lenses and does not require any response from the child. Young children must have dilating drops placed in prior to an accurate prescription for glasses.
Your appointment time is reserved for you. There is a $25 fee for missed appointments without 24-hour notice. If your child is ill, please call our office to reschedule.
Please bring in proper referrals, insurance cards and appropriate co-pays (check with your insurance company if unsure). This is the patient’s responsibility and the office is usually unable to facilitate this for you on the day of the exam. On the day of the exam, if proper referrals have not been made, appointments may have to be re-scheduled along with a $25.00 missed appointment fee.
To reduce your time in the office filling out forms, you may print and fill out the Patient Information Sheet prior to your visit.