The above forms include the HIPAA (Health Information Portability and Accountability Act) form, the New Patient Medical History Form, as well as the Records Release form. If you are a new patient, please print and fill out the HIPAA and New Patient Medical History forms and bring them to your appointment.  We ask that you also plan to arrive at least 15 minutes before your scheduled appointment time.  If you know that you will need records sent to or from Brenart Eye Clinic, please print and fill out the Records Release form.  Additional items you should bring to your appointment (new patient or returning patient) are listed below.

Privacy Policy Form (English)  | Privacy Policy Form (Spanish)

Prepare For Your Appointment:

View Video

Please bring to your appointment:

  1. Insurance cards
  2. Identification card
  3. Updated list of medications and supplements you are currently taking
  4. Primary Care Physician information
  5. Requested forms or documentation (i.e. HIPAA form, New Patient Medical History form, referral reports, exam records etc.)
  6. Most recent pair of prescription glasses
(function(){var s = document.createElement("script");s.setAttribute("data-account","nQM1O9ax3C");s.setAttribute("src","https://cdn.userway.org/widget.js");document.body.appendChild(s);})();Enable JavaScript to ensure website accessibility