APPOINTMENT INFOMATION
Thank you for choosing Pediatric Ophthalmology & the Center for Adult Strabismus. We look forward to participating in your care. Please read the following details in full to prepare for your upcoming appointment.
Please print and complete the applicable form for your needs:
Bring these COMPLETED forms with you to the appointment. Please do not mail ahead of time.
Please bring your insurance card and driver’s license to every appointment.
Without an insurance card we cannot file with your insurance company.
HMO, EPO, POS and any other managed care plans must have a valid referral prior to appointment. Contact your insurance carrier if you have further questions about referrals.
We are not contracted and cannot file claims for vision plans. We will provide a detailed receipt for you to file with your vision plan if necessary.
Co-payments will be collected at the time of service. All non-covered services will be collected at the time of service.
Written consent and copy of driver license is needed if anyone other than a parent or legal guardian is present with a minor (18 years or younger) child. The state law declares that all minors should not be treated unless presented by parent or legal guardian.
If a minor is not accompanied by parent or legal guardian they can not be treated by the physician unless a signed authorization is on file or presented.
If the child is presenting for preoperative appointment a parent or legal guardian must be present NO EXCEPTIONS.
Federal or State Agency presents child for exam they will have court papers indicating they have custody of child.
Please download attached TREATMENT OF MINOR CONSENT FORM if you plan to send someone to the appointment with a minor child.
Food and drinks are not permitted in the waiting room and examination rooms. We respectfully request that ADULTS AND CHILDREN COMPLY WITH THIS POLICY. This includes, but is not limited to: coffee, crackers, cereal, candy, cookies and sodas.
Children & contact lenses: A contact lens prescription is not the same as an eyeglass prescription. A contact lens prescription includes the power of the lens, corneal curvature, diameter of the lens, lens thickness, material of the lens, water contact and brand. The physicians of this practice do not write contact lens prescriptions. Our physicians will do a comprehensive eye examination on your child and will provide you with an eyeglass prescription if one is required. If your child is interested in contact lenses we can refer you to a contact lens specialist for a fitting.
Reminder calls are executed 1-3 days prior to your appointment by the automated system TeleVox®. On rare occasions you may not receive a reminder call. In this event you are still responsible for keeping or canceling the appointment. Informing us of changes to your phone number (& address) assists us in our effort to reach you.
Cancellations of appointments should be made at least 24 hours in advance of scheduled appointment. Appointments may last up to 2 hours. Please plan your schedule accordingly.
Late arrival of appointments: if you are more than fifteen minutes late for your appointment, you may be asked to reschedule. Because we understand your time is valuable we do our best to keep our schedule running on time. Please arrive promptly to ensure this courtesy to everyone.
Refraction is the process of determining the eye’s need for corrective lenses, or the eye’s refractive error. Dilation of the pupil may or may not be required to perform this procedure. Refraction is often necessary in determining a medical diagnosis. Dilation typically occurs no more than one time a year.
A MEDICAL RECORDS RELEASE FORM is required to release medical records, including eye glass prescriptions, to you or any other person, school, employer, business or government agency. If you need to obtain your records, please print the above-mentioned form, complete it and send to the office where you receive your care . It may take up to 14 business days for your records to be sent. Incomplete or illegible forms will delay or prevent the release of medical records.
Download directions to 8222 Douglas Ave, Suite 400 Office |
