Crowley Vision Care


Forms

HIPAA Privacy Consent and Patient Information Form

This form is where you consent to our handling of your medical information in compliance with HIPAA and provide us with the information necessary to establish your account with our office. Fill this out and bring it in if it is your very first visit, or if there are updates to be made, such as names, addresses or insurance information. Download the file here.

Retinal Health Examination and Dilation Consent Form

This form explains what the retinal health examination is, its importance, and its cost. It also allows you to opt in or out of eye dilation. Note that eye dilation only affects very close range eyesight, so it is perfectly safe to drive with your eyes dilated. Download this form here.