Eyeglasses, Contacts, Eye examinations & Lasik - Patient Forms
Patient Forms

This information will be used to provide the doctors at Suresight with a brief medical/vision history and reason for your visit. All personal information is completely confidential and Suresight strictly adheres to all HIPAA regulatory guidelines.

This information will be used to verify eligibility of benefits and file claims with your insurance carrier on your behalf.

Verifies that you have read and understand our privacy policy section of this website. Click on the link below to read our privacy practices disclosure.


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Notice of Privacy Practices