Please find a list of common questions and answers asked by our patients below. You can either type out your question in the box below or view the F.A.Q. (frequently asked questions) categories below.
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Patient Paperwork (5)
You have two options:
- You can come to your appointment 15 minutes early and fill out the necessary paperwork.
- You can print out the new patient paperwork off our website and fill it out beforehand to bring to your appointment.
New patient paperwork links:
- Patient History and Registration Form – English
- Patient History and Registration Form – Spanish
- Health Insurance Portability and Accountability Act Information and Consent Form
Please note that in addition to the above forms, you will be asked to consent to various standard policies upon arriving to your appointment. These include Medicare Authorization, No-Show/Cancellation Policy, Patient’s Rights and Responsibilities, Arbitration Agreement, and Consent, Assignment of Benefits, and Financial Agreement.
When establishing yourself as a new patient, there are various standard forms that need to be filled out completely before your appointment. These forms include the following:
- Patient Demographics: includes important details about you including your address, contact information, date of birth, employer information, etc.
- Medical History: includes your current medications, allergies, past eye medical and eye history, surgical history, and family history.
- HIPAA Information and Consent: this document gives your designees permission to be notified of and have access to your Protected Health Information (PHI).
- Patient’s Rights and Responsibilities: this document outlines the expectations we have of and what you rights are as a patient of The Eye Institute of West Florida.
- Medicare Authorization: this document authorizes us to bill Medicare and Medicaid (when applicable) for rendered services.
- No-Show/Cancellation Policy: this document outlines our policy in regards to patient’s not showing and cancelling appointments.
- Arbitration Agreement: this document informs you of an available dispute resolution process between The Eye Institute of West Florida and the patient.
- Consent, Assignment of Benefits, and Financial Agreement: this document informs you that we will bill your insurance(s) for services rendered.
Upon scheduling your appointment with us, you will be asked how you want to receive your new patient paperwork. If you opted to receive it digitally (online), you will either have it emailed or texted to you. This process typically occurs within 1 (one) hour. You will receive a message with a link to create an account with the Patient Portal (MyPatient Visit). Once you register, your forms will be available in your account.
From the top menu, click or tap “myDocuments” and the select the “Forms” option from the menu drop-down. This section will house all of your outstanding forms. Just click or tap the form to get started. Note that at any time you can click the “Save for Later” option. This allows you to stop the process and go back to resume at a later date/time. Once you have completed all the required questions, click the “Submit” button to send the paperwork to your electronic medical record.
If you are having trouble setting up an account or need an account creation link sent to you, please call (727) 581-8706 or email email@example.com with your and date of birth.
If you are a new patient to our practice (or have not been seen in 3 years) you will be asked how you want to receive your new patient paperwork. Your choices are mailed or sent digitally (via text message or email). If you requested your patient paperwork be sent digitally, please create an account for the Patient Portal (My Patient Visit) within 72 hours of receiving the link. MyPatient Visit will have the required forms for you to fill out.
Yes. If you have not filled out your new patient paperwork prior to your appointment, we request you come in 15 minutes early to fill it out. If you complete your new patient paperwork digitally or filled out the paper copies that were mailed to you, you can arrive just a few minutes before your appointment.
Don’t see an answer to your question?
Visit our contact us page, submit your question, and one of our team members can assist you.
Last modified on April 28th, 2021 at 6:34 pm