The following forms are available online for your convenience.
Please print, fill out, and bring with you to your appointment.

Patient Information & Payment Policy Forms

Medical History Questionnaire & Review of Systems Forms

Privacy Policy

CareCredit® Healthcare Finance - Payment Plans and Financing for Cosmetic Surgery, Dental, Vision, Hearing, Veterinary & Other Medical Procedures

CareCredit can help finance your LASIK and vision care needs. With CareCredit, you can correct your vision and finance eye care procedures such as cataract removal and LASIK eye surgery.

Payment Calculator

Enter amount to calculate your monthly payment.

CareCredit for Better Vision

When to have your vision procedure should be the question, not how to pay for it. We'd like to make that decision even easier for our patients. That's why we're pleased to offer the CareCredit card, North America's leading patient payment program. CareCredit lets you begin your procedure immediately -- then pay for it over time with monthly payments that fit easily into your monthly budget. Now you don't have to save up for years to finally get the vision you've always wanted. We'll help you see clearer, sooner.

Your healthcare credit card

CareCredit is the credit card exclusively for healthcare services. CareCredit offers monthly payment plans for healthcare procedures not commonly covered by insurance, including LASIK. Don't put off improving your vision. Get your procedure now.

For vision procedures CareCredit offers:

Enjoy minimum monthly payments
Pay no up-front costs or pre-payment penalties

Learn more by visiting CareCredit.com or contacting our office. Ready to apply? Apply online for your CareCredit card today. You'll be seeing clearer in no time.