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Tozer Lee Eye Center
Scottsdale
9811 N 95th Street • Suite 101
Mesa
1830 S Alma School Rd • Suite 102
Call
480.947.4493
Scottsdale
9811 N 95th Street • Suite 101
Mesa
1830 S Alma School Rd • Suite 102

Call 480.947.4493

  • About
    • About Us
    • Meet Our Providers
      • Dr. Michele Lee
      • Dr. Kevin Tozer
      • Dr. Christina Sorenson
      • Dr. Kim Dankha
      • Dr. Michelle Hammond
    • FAQs
    • Patient Reviews
    • Newsletter
    • News & Info
  • Eye Care
    • Optometry & Optical
    • Ophthalmology
    • Cataract Surgery
    • Corneal Cross-Linking
    • Corneal Disorders
    • Diabetic Eye Disease
    • Dry Eye
    • Hard-to-Fit Contacts
    • LASIK / Refractive Surgery
    • Macular Degeneration
  • Eyewear
  • New Patients
    • Patient Forms
    • Payment Options
  • Contact
  • Patient Portal & Payments
    • Patient Portal
    • Payments

Patient Forms

Patient FormsManager2025-08-03T23:44:58-07:00

Save time by downloading and completing patient forms prior to your appointment.

New Patient Registration Form

  • New Patient Registration Form
  • New Patient Registration Form (En Español)

Medical History Form

  • Medical History Form
  • Medical History Form (En Español)

Release of Medical Records

  • Release of Medical Records
  • Release of Medical Records (En Español)

Privacy Notice

  • Privacy Notice
  • Privacy Notice (En Español)

HIPAA PHI Release

  • HIPAA Compliance
  • HIPAA Compliance (En Español)

Financial Agreement

  • Financial Agreement
  • Financial Agreement (En Español)

Consent to Treat Minor Children

  • Consent to Treat Minor Children
  • Consent to Treat Minor Children (En Español)

Patient Code of Conduct

  • Patient Code of Conduct
  • Patient Code of Conduct (En Español)

No Surprise Billing Notice

  • No Surprise Billing Notice
  • No Surprise Billing Notice (En Español)

See Us Today in Scottsdale & Mesa

See Us Today
In Scottsdale & Mesa

Call 480.947.4493

Tozer Lee Eye Center

Scottsdale
9811 N 95th Street, Suite 101
Scottsdale, AZ 85258
View Map
Phone 480.947.4493
Fax 480.947.4751

Mesa
1830 S Alma School Rd, Suite 102
Mesa, AZ 85210
View Map
Phone 480.947.4493
Fax 480.947.4751

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Terms of Service
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