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NEW PATIENT FORMS
We'd like to welcome you to our office. To best serve your visual and eye care needs, please print and complete the Patient Information Form. You may mail it to our office, scan it and email back to info@bengoaeyecare.com, or bring it to your appointment. Please also review our "Notice of Privacy Practices". When you come for your appointment please bring all eyewear materials. If you are a contact lens wearer, please arrive wearing your contact lenses. We look forward to being a part of your vision care for years to come!
 

Patient Info Form

 

Notice of Privacy Practices FormNotice of Privacy Practices

The forms on this page are in Adobe pdf format. If you are unable to view

them you may need to download the free Adobe Reader with the link below.

Get Adobe Reader
 
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