New & Existing Patients
Welcome!
The following are forms that are required for your appointment. Please save yourself some time by printing and completing the forms below. Please bring them to your appointment along with your ID and insurance card. Please arrive 15 minutes prior to your appointment time. Thank you for choosing our practice for your ophthalmic care!
Annual Exam Waiver Health History Form HIPAA History Form Patient Demographic Form (Adult) Patient Demographic Form (Child) Consent to Treat a MinorTo Request Medical Records
Please complete the Medical Records Release Authorization Form and either:
Email it to: medicalrecords@danburyeye.com, Fax it to: 203-403-9850, or Mail it to:
Attn: Medical Records Department
Connecticut Eye Consultants
69 Sand Pit Road
Danbury, CT 06810