Before your visit, we need you to verify your insurance. Links to most insurance companies are on the right side of your screen under “Links” (if your insurance is not there, please contact your insurance company or human resources department). Please ensure that we are providers for your insurance. Check your coverage! You may have certain benefits that your are entitled to, like a routine exam annually. Also, please check to see if you have a vision plan. We need this information before your visit to ensure that it is filed properly, unfortunately, this can not be changed after your visit. Thank you in advance for your cooperation.

Forms Available:

• Patient Demographics

• Medical History

• Office Policy

• Medical Records Release to and from K.C. Eye Specialists

There are three forms to complete for appointments:

Step 1. Read all of these instructions, then click on  Patient Demographics

Step 2. Complete the form entirely.

Step 3. To sign the form you will need to create a “Digital ID”.

(You will have 2 options. See below. We recommend “Windows Certificate Store” You only need your name and e-mail address.)

Step 4. Click on “Submit Form” at the top of the screen.

Step 5. Click on Medical History Questionnaire complete that form and submit it.

Step 6. Click on Office Policy complete that form and submit it.

For Medical Records Release:

Step 1. Click on Medical Records Release to K.C. Eye Specialists or

Medical Records Release from K.C. Eye Specialists

Step 2. Complete the form entirely.

Step 3. To sign the form you will need to create a “Digital ID”.

(You will have 2 options. See instructions above. We recommend “Windows Certificate Store” You only need your name and e-mail address.)

Step 4. Click on “Submit Form” at the top of the screen.

If the “Submit” button does not work, save the file to your computer, then attach it in an e-mail it to kceye@swbell.net