Appointment information and forms
University Eye Specialists are providers for many different insurance companies. Payment is appreciated at the time of your visit unless other arrangements have been made in advance. We accept Medicare assignment and, as a courtesy, assist in submitting other insurance claims for you if you have all necessary information for your primary and secondary insurance. University Eye Specialists does not participate in any vision plans — your eye exam is billed to your medical insurance plan instead. Please remember to bring your insurance cards and state ID with you so we may copy them for your records. With your help, we can assure that you will receive all the insurance benefits that are available to you through your policy.
Fee for refraction
The cost for refraction (measurement for glasses or contact lenses) is not covered by Medicare and most other insurance carriers. The doctor's fee for this service is $50.00 and is charged only when a new prescription for glasses is given to you. Contact lens fitting fees are not billable to insurance. We require that you pay for your fitting at the time of service. We provide you with an itemized receipt that you can submit to your insurance plan if you choose.
Required registration information for your appointment
To streamline the check-in process on your appointment day, please provide us with your medical history and demographic information prior to your visit by clicking on the Online Registration link below. The medical information you provide online will automatically pre-fill into your electronic medical chart in our office, thereby allowing us to check you in on the day of your appointment more quickly. This information is delivered over a secure server that is HIPAA compliant. Please allow yourself 10-20 minutes to complete the online registration in its entirety.Online Registration
If you do not register online, please download and print out the New Patient Medical History form and New Patient Registration form below and arrive 15 minutes prior to your scheduled appointment time with these documents completed.
Required registration forms
- New Patient Medical History form (pdf)
- New Patient Registration form (pdf)
- Release of Information to Family Members (pdf)
Other important forms Related to your appointment
Forms for releasing and sending medical information
- Authorization for Release of Information to University Eye Specialists (pdf)
- Authorization for Release of Medical Record Information from University Eye Specialists (pdf)
Form for referring physician or referring ophthalmologist
- Physician Referral form (pdf)
Arrive prepared for your appointment
When you have your first eye exam at University Eye Specialists, please plan on spending one and one-half hours in our office. Your examination may be longer depending on the severity of your condition or other specialized testing. Your comprehensive exam will include dilation of your pupils. Dilation is an important aspect of your eye examination because it allows us to thoroughly examine your eyes, including your retina. Dilation of the pupils can cause light sensitivity and difficulty seeing up close. Blurred vision typically lasts 3-6 hours. We suggest bringing a pair of sunglasses and someone to drive you home if that is your mode of transportation. You will be able to walk and/or use public transportation without assistance.
Complementing the surgeons of University Eye Specialists is a dedicated staff of technicians who support the high-quality vision care we deliver to our patients. Our physicians personally train all of our technicians. Depending on your ocular condition and what your doctor needs to thoroughly evaluate your eyes, our ophthalmic technicians also carry out specialized testing.Back to top