Patient Forms.
Welcome to the office of EyesWest Optical. To better serve your optical needs on the day of your visit, please download, print, and complete these forms before arriving at our office. If a minor (under 18 years of age) will be seeing a doctor for an exam, a legal guardian must complete and sign the consent form and accompany the minor during the complete exam and visit to our office.
CLICK FOR: Patient Intake Form
Please fill out both pages completely.
CLICK FOR: HIPPA, Insurance, and Financial Policy Form
Be sure to date and sign this form.
When visiting, please bring:
Completed paperwork.
Your driver’s license.
Your insurance cards if applicable.
Your previous eyeglass and or contact lens prescription if available.
Any other paperwork relevant to your appointment and care.
If you have any questions, please call the office at 623.583.0344.
In accordance with HIPAA regulations, please do not share any protected or confidential health information when using this form. Although unlikely, there is a possibility that the information you submit could be intercepted and read by parties other than the intended recipient. To protect your confidential information, please do not share personal identifying information such as your personal medical information or birthday in any website submissions or emails sent to us.
Insurance Plans
At EyesWest Optical, we’re committed to making quality eye care accessible and convenient for everyone.
Our friendly staff will help you navigate your insurance benefits and ensure you get the most out of your coverage. Visit us today and experience hassle-free eye care tailored to your needs.