Access our patient forms that you can fill out before your next visit to Shillington Eye Associates in Shillington.
-Please review both the HIPAA form and the Financial Policy form. You may print copies of these if you like. After reviewing these two forms, please print and fill out both Acknowledgement forms below. Additionally, please print and fill out the New Patient form and the Notice of Exclusion form. Bring the New Patient form, the Notice of Exclusion form, and the Acknowledgement forms to our office at the time of your appointment.
- New Patient Form [PDF]
- HIPAA Form [PDF]
- Financial Policy [PDF]
- HIPAA Acknowledgment [PDF]
- Financial Policy Acknowledgment [PDF]
- Notice of Exclusion [PDF]