New Patient Information and Forms

• For your convenience, you may complete new patient forms in advance. Click the green button to download, print, and fill out the necessary paperwork.

  • Please bring a completed copy of these forms to your appointment

  • Alternatively, you can email a completed form to RidleyCreekRetina@gmail.com

• We recommend that you bring:

  • Valid form of ID

  • Insurance card(s)

  • List of current medications and dosage

  • A copy of any important prior records

  • Form of payment if co-pay/deductible is required

Payment Policy

• Payment in full is expected at each visit. Payments can be made in the form of cash, personal check or credit card. We accept MasterCard, Visa, Discover and American Express.

Co-payments and Deductibles

• All co-payments and deductibles must be paid at the time of service. Please check with your insurance company to know the contribution you are expected to make towards your visit.

Insurance

• We participate in multiple insurance plans, excluding Medicaid. If you are insured by a plan we do business with, present your current card at your visit so that we may verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

Coverage Changes

• If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.