Epstein Eye Associates

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Patient Forms

Access our forms
To assist us in our goal to see patients on time, we appreciate your assistance in completing the following 3 forms.  Please print them out and complete them prior to your visit.  
  1. NEW PATIENT INFORMATION SHEET - Your Medical and Vision history helps us to assess your overall health and provide you with your best possible vision. 
  2. OCT SCREENING - Be sure to read about our newest technology, the OCT screening.  You will have the opportunity to have this diagnostic test performed during your visit. 
  3. NPP ACKNOWLEDGEMENT OF RECEIPT.  This form simply acknowledges that you were provided with the opportunity to view/print our Privacy Policy.  Our Notice of Privacy can be viewed by clicking on the link at the bottom of our HOME page.
**NEW PATIENT FORMS PACKAGE**
File Size: 987 kb
File Type: pdf
Download File

**NPP ACKNOWLEDGEMENT OF RECEIPT**
File Size: 160 kb
File Type: pdf
Download File

**OCT SCREENING**
File Size: 680 kb
File Type: pdf
Download File

Thank you for your assistance in completing these 3 forms.  We look forward to seeing you at your appointment!
EPSTEIN EYE ASSOCIATES
169 CHRISTIANA ROAD
NEW CASTLE, DE 19720
302-322-4444
OFFICE HOURS:
MONDAY    9 A.M. - 7:30 P.M.
TUESDAY 9 A.M. - 5:30 P.M.
WEDNESDAY 8 A.M. - 12 NOON
THURSDAY 9 A.M. - 7:30 P.M.
FRIDAY 8 A.M. - 2 P.M.
Notice of Privacy Practices
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