New Patients

New Patients

Welcome new patients and thank you for trusting us with all your family eyecare needs. We are looking forward to your first visit! To help facilitate your appointment, please visit our Patient Portal to complete your Patient Information and Medical History information.

Once you have completed all of the Patient Information and securely submitted it online, please read and sign each of the following documents to complete your registration prior to your visit.

 

Patient Portal

Zionsville Eyecare is excited to offer our new secure Patient Portal for patient registration.

Please click here to get started.

WTTO

Once you have completed all your Patient Information and securely submitted it online, please read and sign each of the following documents to complete your registration prior to your visit.

  • Zionsville Eyecare Policy – This form combines our standard HIPAA (Health Insurance Portability and Accountability Act) form about how we may use or disclose your health information and our payment policy which states you are in agreement to be financially responsible for any portion of your visit that insurance does not cover. By clicking on the link, you will be able to download, review, and sign the documents.
  • Zionsville Eyecare Optomap – Please complete this form about whether or not you would like to participate in our advanced screening procedure. By clicking on the link, you will be able to download, review, and sign the document.