Patient Information

• A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and eye history
• Contact lens wrappers/boxes
• Any glasses you wear

Patient Forms

For your convenience, please print and complete the following patient forms before your visit:

• Patient Registration Form
• Patient Authorization Form for Protected Health Information
• Financial Policy

[information on accessing and printing forms]

Mecklenburg Eye Associates
Toll Free: 1.800.628.EYES (3937)

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