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Prior To Visit - Download & Print Patient Information Form

We greatly value your trust in our eye care services. To ensure your visit with us is as efficient and tailored to your needs as possible, we kindly request that you complete our Patient Information Form prior to your appointment. This step not only expedites the check-in process but also allows our team to better understand your medical history and specific requirements.

Patient Info Form

Why Completing the Patient Information Form is Important:

Personalized Care: Filling out this form ensures that our eye care professionals have a comprehensive view of your health history, eye conditions, and any medications you may be taking. This enables us to provide you with personalized care that aligns with your unique needs.

Time Efficiency: We understand that your time is valuable. By completing the form in advance and bringing it with you to your appointment, you help us streamline the check-in process, reducing wait times and ensuring a smoother overall experience.

How to Complete the Patient Information Form:

Complete the Form: Take your time to fill out all sections of the form accurately. Be sure to include any relevant medical history, allergies, and current medications.

Bring it With You: On the day of your appointment, remember to bring the completed form along with any insurance information or identification that may be required.

Your Medical Privacy Matters:

Rest assured that all the information you provide on this form is handled with the utmost confidentiality. Your privacy is important to us, and we strictly adhere to industry-standard privacy practices. Download the privacy practice form here. 

We appreciate you choosing Vision Clinic, Dr. Savin and Associates for your eye care needs. We look forward to serving you and ensuring your vision is in the best possible hands. Should you have any questions or need assistance with the form, please don't hesitate to fill out our contact form below. Financial Policy Form

We are committed to providing you with exceptional eye care services. To help you understand our financial policies and ensure a seamless experience with us, we have outlined our financial policy below.

Financial Policy Form

We are committed to providing you with exceptional eye care services. To help you understand our financial policies and ensure a seamless experience with us, we have outlined our financial policy below. Download our Financial Policy Form Here. 

Payment Options:

We offer various convenient payment options to accommodate your needs:

Insurance: We accept a wide range of insurance plans to help cover your eye care expenses. Please see the "Most Insurance Plans Accepted" section below for a list of the insurance plans we work with.

Out-of-Pocket: For those without insurance coverage, we accept payments via major credit cards, checks, and cash.

Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA): You can use your FSA or HSA funds for eligible eye care expenses. Our team can assist you in navigating this process.

Understanding Your Insurance Coverage:

Navigating insurance policies can be complex, but we're here to help. Before your appointment, we recommend contacting our office or your insurance provider to verify your coverage details, copayments, and any out-of-pocket expenses you may be responsible for.

Billing and Statements:

After your visit, you will receive an itemized statement detailing the services provided and any associated charges.

If you have insurance coverage, we will submit claims to your insurance provider on your behalf.

Payment Plans:

If you have financial constraints, please discuss them with our team. We are committed to finding solutions that work for you, which may include setting up a payment plan.

Most Insurance Plans Accepted:

We understand the importance of affordable eye care. That's why we work with a wide range of insurance providers to help cover your eye care needs. Here is a list of some of the insurance plans we accept:

• VSP (Vision Service Plan)
• Eyemed
• Davis Vision
• Medicare
• Blue Cross Blue Shield
• United Health Care

Please note that this list is not exhaustive, and we work with many other insurance plans as well. If you don't see your insurance provider listed, don't hesitate to contact us for verification. Our team will assist you in understanding your coverage and benefits to ensure you receive the most from your insurance plan.

We understand that navigating insurance can be confusing, and our knowledgeable staff is here to assist you in maximizing your benefits and minimizing your out-of-pocket expenses.