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Patient Forms

Registration Form

Download the Patient Registration Form with the link above. Open with Adobe Reader, fill out all the information and print to bring to the office before your visit.

Hauser-Ross Eye Institute

Patient Medical History Form

Consent for Care and Treatment – ENG | ES

Notice of Billing Practices – ENG | ES

Privacy Practices Acknowledgement – ENG | ES

Hauser-Ross Optical

Patient Medical History Form

Consent for Care and Treatment – ENG | ES

Notice of Billing Practices – ENG | ES

Privacy Practices Acknowledgement – ENG | ES

Lawrence Eye Care – Hauser-Ross Eye Institute

Patient Medical History Form

Consent for Care and Treatment – ENG | ES

Notice of Billing Practices – ENG | ES

Privacy Practices Acknowledgement – ENG | ES

Hauser-Ross Eye Institute – VZN Eyecare

Patient Medical History Form

Consent for Care and Treatment – ENG | ES

Notice of Billing Practices – ENG | ES

Privacy Practices Acknowledgement – ENG | ES