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New patients should arrive 15 minutes early for their appointment. Existing patients should arrive five minutes early.
Confirm or change your appointment online.
Request your appointment online.
Obtain Information / history forms to complete prior to your appointment
(click the links below or pick them up at our office):
These online forms can be filled out on screen and printed for you to bring with you to your appointment. Should you have any problems with or questions about these online forms please contact us via E-Mail, using our contact form or call our office at (731) 686-8642.
Requires Acrobat Reader installed on your computer. To download a free copy of Acrobat Reader, click here.)
Adult Information / history form
Children's Information / history forms must be completed and signed by the person responsible for the child's account (parent or legal guardian) and the child must be accompanied by this responsible party to authorize treatment.
Child Information / history form
A note about our Acrobat forms:
These forms have been designed to allow you to fill them out on screen and print the completed form to your printer.
Due to the confidential nature of the information on the completed forms, they may only be printed. Due to the insecure nature of e-mail and other forms of electronic transfer, the completed forms cannot be sent electronically. The information entered on these forms is not stored in any way by this web site.
Having these forms completed when you sign in for your appointment will save you a great deal of time. Accurate and complete information will allow the doctor and our staff to serve you better.
Be sure to complete the list of medications that you are presently taking or bring a type written list (possibly available from your pharmacy) or bring all the bottles when you show up for your appointment.
Be sure to bring all current insurance cards (medical and vision) to your appointment. Verifying coverage with your insurance carrier / administrator prior to your appointment and bringing any information, forms, authorizations, etc... can assist our staff in proper claims handling and prevent you from having any surprises.
- If you have vision or medical insurance, we will need to make copies of your cards.
- We will file your vision / medical insurance claim for you; however, we ask that you pay any co-payment and deductible at the time service is rendered. We do accept cash, check, or credit cards.
- If you do not have vision or medical insurance, payment is expected at the time service is rendered.
- We will be glad to bill your vision / medical insurance for any procedures you received. If the insurance does not pay, you will be responsible for the bill in full.
- It is your responsibility to advise us when there are any changes in your address, phone, or insurance information. Failure to advise us of correct insurance information can cause delays and even denials of payment due to timely filing. If denial occurs due to your failure to advise us of correct information, you will be responsible for payment of that date of service.
Confirm or change your appointment online
Request your appointment online.
The American Optometric Association recommends a "dilation" eye exam every 12 months.
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