Patient Forms

Carolinas Eye Center ensures the safety and privacy of the information you give us. On your first visit, our friendly staff will ask you to fill out some forms to become part of our patient records.

At our Carolinas Eye Centerwe adhere to HIPAA rules and policies. We ensure that all the information in your patient forms will be kept confidential. Any information will not be shared with other individuals or entities without your prior consent.

For your convenience, you may download the forms below, print them, and complete them before your appointment.

You may contact us at 704-510-3100 and schedule an appointment today!

ENGLISH:  PATIENT HISTORY

                    DEMOGRAPHICS

                    PRACTICE POLICIES

ESPAÑOL:  INFORMACION GENERAL

                    HISTORIA DEL PACIENTE

 

THANK YOU

Ashley from the office will be calling to provide more information and schedule your appointment.  We can’t wait to “see” you…