Patient Information Forms

Patient information forms are available by clicking the form title below. Please print, fill out the form, and bring it with you to our office for you appointment. You may also fax your information to our office prior to your appointment at (770) 867-2359.


New Patient Information FormPatient information forms are available from this page.

Returning Patient Information Form

Consent to Treat a Minor

Retinal Photography Form

Notice of Privacy Practices

Medical Release Form

Please be advised that all scheduled appointments not cancelled 24 hours in advance will be subject to a $25.00 cancellation fee.

Most medical and vision insurances are accepted and filed for your convenience.

We participate with VSP, Medicare (all Medicare supplemental policies), Medicaid,  Aetna, Cigna, Cigna HealthSpring (Block Vision), Ameritas, AAHPS, BCBS, Davis Vision, EyeMed, Avesis, Opticare (Peachstate), Care Improvement Plus, Superior Vision, VBA, VCP/Comp Benefits, Humana and United Health Care.

Call today for your appointment. Our knowledgeable staff can help answer any questions about what your insurance plan covers before your appointment.  This avoids any surprises about your charges when you arrive!

We accept cash, personal checks, ATM, American Express®, MasterCard®, Visa®, and Discover®.

Contact us at  770•867•1913