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Drs. Fine, Hoffman & Sims Opthalmologists in Eugene Oregon

Forms

Patients now have the option of completing and/or updating all necessary demographics in Green fashion by utilizing our Patient Portal. Please click here to enter our Patient Portal.

Below are a few of the forms you may be asked to fill out whether you are a new patient or a long time patron. We will ask for this essential information to be renewed every year to help us provide you with the best care possible and to fully inform you of the billing process. We also are constantly reviewing patients’ insurance information to help ensure proper billing for your appointments. To facilitate an expedited visit be sure to have your most current insurance cards and medication list as well as the appropriate forms found under the “Patient Registration Packet” section.

Patient Registration Packet

HIPAA Privacy Notice - Summary  - (updated 09-13)

HIPAA Privacy Notice - Detailed - (updated 09-13)

Additional Insurance Information

Refilling Your Glaucoma Eye Drops

Medical Records Release Form

Strabismus History Form

Informed Consent Forms:

If you are considering surgery for improved quality of life, please complete and bring this form to your appointment.
Pre Operative Quality of Life Vision Questionnaire

New! Patient Portal

Feel free to call or drop in if you'd like to speak to someone in person.

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You'll need Adobe Acrobat to open the forms listed to the left.

You can download the program by clicking the button below.