At Tozer Lee Eye Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
- You will need AdobeReader® to download and complete the forms.
- Download the required form(s). Print out the form(s) and complete the required information.
- Fax your printed and completed form(s) to our office at 480-947-4751 or bring them with you to your appointment.
Patient Information Sheet
This form will help us collect all of your personal information. This form is required for all new patients.
Patient Information Sheet (PDF)
¡También en español!
Release of Medical Records
This form will help us procure your medical records from your existing primary care physician or eye specialist. This form is required for all new patients.
Release of Medical Records (PDF)
¡También en español!
HIPPA Compliance
This form must be completed and signed for all new patients.
HIPPA Compliance (PDF)
¡También en español!
Consent to Treat Minor Children
This form must be signed by a parent/guardian for any patients under the age of 18.Consent to Treat Minor Children (PDF)¡También en español!
Medical History Form
This form will help us gain an understanding of your medical history. This form is required for all new patients.
Medical History Form (PDF)
¡También en español!
Privacy Notice
Please review our privacy notice carefully. This form is required for all new patients.
Privacy Notice (PDF)
¡También en español!
Financial Agreement
This form must be completed and signed for all new patients.
Financial Agreement (PDF)
¡También en español!