Patient Forms

Thank you for choosing Eyes on Albertville & Eyes on Guntersville! There are forms below that can be printed and completed before coming to our office. Please complete both the HIPAA form and the Medical History form.

HIPAA

 

A HIPAA authorization form is a document in that allows an appointed person or party to share specific health information with another person or group.

Info & Medical History

This form allows you to share personal information with us. 

Just like your family's medical history, your own medical history can help your eye doctor monitor your vision and alert them to warning signs that could lead to eye complications and blindness.

Info & Medical History (Spanish)

Esta forma es para que da Esta forma es para que dar tu informacion personal con nosotros.

Igual como la historia medical de tu familia, tu propio historia medical vas ayudar tu occulista a chequear tu vision y darles alertas de advertencia que pueden afectar los ojos con complicaciones y enfermedades que puede causar siego.

Schedule your eye exam today!

256-878-3024

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200 S. Hambrick Street

Albertville, AL 35950

390 Gunter Avenue

Guntersville, AL 35976

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