New Patient Registration Forms

Prior to your initial visit, please fill out your paperwork digitally using the link below:

If you prefer, you may also download the forms and fill them out manually instead. They may be faxed to 212-696-1190 before your visit or brought with you. Download and fill out each of the following forms:

Patient Demographics
Patient Medical History
Authorization and Consent / HIPAA
Refraction Policy / Fees
Dry Eye Questionnaire
Notice of Privacy Practices

Cataract Evaluation Forms and Questions

If you have questions about your surgery or would like to perform a self-evaluation prior to your consultation or surgery, please use the following forms:

Visual Freedom Brochure: Your Refractive IOL Options
Preparing For Your Initial Visit
Cataract Questionnaire
Visual Function Questionnaire

Patient Forms

New Patient Registration Forms

Cataract Evaluation Forms and Questions

Schedule Your Appointment Your Vision Awaits