We are pleased to welcome new patients to our practice!
For your convenience you can print and complete the following Patient Information Forms to bring with you to your appointment:
- New Patient Form
- Patient Consent Form
- Medical History Questionnaire
- Electronic Medical Records Info
- Notice of Privacy Practices
- If you are using Medicare
- Optomap Retinal Exam Form
- Optomap Example Sheet
We accept many eye insurance plans, including VSP. If we don’t take your insurance, we’ll help you file for reimbursement. Eye care services and products also qualify for your flexible spending account. There are so many plans available, please give us a call to discuss yours.
Thank you for choosing Eyecare Center of Leesburg for your eye care. We strive to provide the best services and quality care possible. We also strive to have the same level of quality when billing for our services. This guide will serve to assist in getting your services paid: