Patient Forms
For your convenience, we have made a number of forms available for patients to download. If you are new to our practice, we encourage you to download and print out the new patient forms. Filling these out in advance of your first visit will minimize the time you spend in the waiting room filling them out when you get here. Other forms are informational.
If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you’re not sure which forms you need, please call 800-624-8254 for assistance or email us your questions using the form.
Click on the forms you would like to download:
- Patient Registration
- Medical History Information
- HEC Financial Policy
- HEC Audio Video Policy
- Notice of Privacy Practices
- Notice of Non-Discrimination
- Interpreter Assistance Information
If you’re unable to open these files, you probably need to download the free Adobe Acrobat Reader program, which is available at the following location: www.adobe.com/products/acrobat/readstep.html
Get In Touch With Us:
To learn more about Hattiesburg Eye Clinic and our services please call us at 601 268 5910 or toll-free at 800 624 8254 or schedule a consultation.
