These forms/packets can be printed and brought into the office, or emailed to email@example.com. Please note that we require signatures or initials be handwritten, and so we may have these records printed and ready for your next visit to the office to obtain those handwritten signatures or initials.
Patients will need to sign this form to allow family/friends to access their protected health information (PHI). Please note that children that turn 18 will need to fill out and sign one of these forms in order for their PHI to be able to be shared with their parents.
Patients will need to sign and date this form in order to submit their own frame to Vision Plus to have prescription lenses made. Please note that all patient pre-owned frame jobs are subject to Optician Approval, and regardless of approval, Vision Plus is not liable for any damages done to frames during the insertion and removal of lenses, frame adjustment and alignment, or any other manipulations requested by the patient.