One of the highest values at Virginia Eye Institute is to not only help improve your sight, but to educate you throughout the process. We make this possible through one-on-one interactions with you as a patient, as well as through the various resources provided below.
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit.
- Patient Registration Form
- Patient General Responsibility Form
- Patient General Responsibility Form – Spanish
- Financial Policy – Spanish
- Third Party Consent to Treatment of Minor
- Authorization to Release Protected Health Info
- Authorization to Release Protected Health Info – Spanish
- Medical Records Request Form (PDF | Online)
- Notice of Privacy Practices
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.