Clients are required to complete a consulting agreement prior to work being performed. A monthly maintenance agreement is also required to participate in our Monthly Maintenance Program. In addition, the Health Insurance Portability and Accountability Act (HIPAA) requires Medicare providers to obtain a Business Associate Agreement from entities they engage that may have access to confidential patient information. HIPAA requires this agreement to protect patient privacy.

As a courtesy to current and prospective clients, these agreements may be downloaded below.

Consulting Agreement Monthly Maintenance Agreement Business Associate Agreement

Please take a few minutes to review the forms below and compare them to the forms currently in place in your practice. As a courtesy to current and prospective clients, any of the forms may be downloaded for your use.

Advance Beneficiary Notice Deluxe Frames Waiver DME Supplier Standards Extended Ophthalmoscopy Sheet Financial Hardship Waiver Interpretation & Report- Generic Interpretation & Report- Pachymetry Lifestyle Impairment Questionnaire NEMB - Astigmatism-Correcting IOLs NEMB - Presbyopia-Correcting IOLs Obtaining Chief Complaints Patient Authorization Prescription for Glasses Transfer Of Care Form

Need Adobe Acrobat Reader? If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon 'Get Acrobat® Reader'. This will take you to Adobe's website and enable you to download the Acrobat program to your computer.