Eye Care for the Adirondacks-Patient Surgery Forms

Surgery Patient Forms

Complete forms at home and bring them with you to your appointment.

Click Here to open Healthcare Proxy Form

Click Here to open Insurance HIPAA Consent Form

Click Here for Physician Ownership Disclosure Form

Click Here for Medication Reconciliation List

Click Here for Patient's Bill of Rights Form

Click Here for Advanced Directives Information Form

Malone Office and Optical Shop | 14861 State Route 30 | Malone, NY | 12953 | 518.483.0065
Saranac Lake Office and Optical Shop | 51 Woodruff St. | Saranac Lake, NY | 12983 | 518.891.8412
Eye Care for the Adirondacks | 450 Margaret St. | Plattsburgh, NY | 12901 | 518.566.2020 | 800.272.1003