It is always our goal at West Michigan Eyecare Associates to give you the eye care you deserve in a timely manner.
In order to ensure that your first visit goes smoothly, you may want to complete the forms below prior to your visit. If you print hard copies of this paperwork, please bring it completed to your appointment. Thank you for helping us prepare for your appointment.
New Patient – Adult
New Patient – Pediatrics
We value patient privacy and do all we can to protect your information. Please review our Notice of Privacy Practices to be informed about how we may use or disclose your protected health information.
Privacy and Financial Policies And Agreement
This form notifies you of our Financial Policies and summarizes our Privacy Practices. Please bring this completed form with you to your first visit.
Fill Out Online | Download & Print
Records Release Forms
Please complete the appropriate form below and email (firstname.lastname@example.org) or fax (616-949-2878) to us to begin the process to transfer your medical records.
Transfer of Medical Records to Our Office – PDF download and print or Submit online
Transfer of Medical Records From Our office – PDF download and print or Submit online
You will need Adobe Reader® installed on your computer. If you don’t have it, click here to download it. Click Here to download.
If you have any questions about our office or our forms, don’t hesitate to contact us today at (616) 949-8500.