Eye center of southern connecticut will be closed on Thursday, December 17 due to the snow. We will reopen for business on Friday. Please stay warm and safe!

New Patient Forms

Click on each link and open the form directly in your browser; you will now be able to print the form selected. Please note that you will need an updated version of Adobe Acrobat Reader in order to download all forms.

Please fill out each form completely and bring it with you to your first office visit.

Please also remember to bring with you any referral, copay, or deductible you may owe as according to your insurance plan. In addition, bring your insurance card so that we can make a copy for your file.

All minors must be accompanied by a parent or legal guardian.


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