Patient Forms

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment. So that we may better assist you in a timely manner, we ask that you bring the following to your appointment and arrive 10 minutes prior to appointment time to allow for the check in process:

1.   Driver's license or other photo ID;

2.   Current health insurance card(s)    

  Medical Record Requests can be made by faxing a release to 205.397.9455 . Medical Records Department # : 397.9430

Downloadable Forms: 

 Thank you for your confidence in our office, we look forward to assisting you with all of your eye care needs. 

New Patient Forms

Notice of Privacy Practice 

Current Patient Update

       

Release of Records FROM AL EYE

Release of Records TO AL EYE

HELP PREVENT THE SPREAD OF RESPIRATORY VIRUSES LIKE COVID-19 AND FLU: 

o   Please notify the office if you are experiencing any acute respiratory symptoms or have been in close contact with someone who has experienced acute respiratory symptoms and has traveled to an affected area.

o   If you have the symptoms described above, we ask that you reschedule your appointment, self-quarantine and seek medical attention from your primary care provider for your acute respiratory symptoms.

o   We will reschedule your appointment as quickly as possible once you are feeling better.


 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.