Patient Forms

Please print out and complete the forms below prior to your initial visit with us.

Patient Info
Medical History
Patient Consent for Use of and Disclosure of Protected Health Information

Insurances Accepted

Aetna
Blue Cross/Blue Shield
Cigna
Eyemed
Fidelis
Independent Health
Univera
VSP

Comprehensive list forthcoming.

Hospital Affiliations

DeGraff Memorial Hospital
Kenmore Mercy Hospital