Welcome to Eye 2 Eye!
New patients, please take a moment to complete our Online Patient Welcome Form. Simply click on the link below, fill in your information and submit directly to our office!
We do require your social security number. Please note, that the online form is 100% secure and your personal information will not be shared or be subject to identity theft. If you are not comfortable submitting your social security number or other personal information online, please feel free to call our office to give us that information over the phone.
1. Please FILL OUT THIS FORM as completely as you can. If it is not complete, please arrive 15 minutes before your appointment time to complete the information.
2. DO NOT USE DASHES in the social security number
3. When you are filling out the form, please DO NOT hit your browser's Back button as you will lose any information already entered
Insurance Information
For those insurances that we are an in-network provider, we will gladly check your insurance benefits and bill your insurance for your eyecare. Note that all quotes from insurance companies are never a guarantee of payment.
WE ARE A PROVIDER FOR:
- Vision Service Plan
- Davis Vision
- Blue Cross
- Blue Shield
- Tricare
- First Health
- Medicare and True Blue
- Medicaid
- CBSA
- Riverside Benefits
- Aetna
-
Pacific Vision Care
-
Blue Cross Federal (Medical ONLY)
WE ARE NOT A PROVIDER FOR:
- Eyemed
- Spectera
- Cole Managed Vision
- Vision One
