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Patient Forms and Information

Thank you for choosing Boston University Eye Associates where our goal is to provide you with exceptional care without exception. To save you time at check in, please print and fill out the forms below and bring them with you at the time of your appointment (all forms are .doc format).

 

Read Only:

HIPAA Privacy Notice

Fill Out and Bring With You:

HIPAA Signature Form

Business Office Policy Signature Form

Pediatric Health Questionnaire (under 18)

Records Release Form

Insurance Information:

On the day of your appointment, bring your insurance cards with you. If your insurance requires a referral, please request one from your primary care physician prior to your appointment.

Make a Payment:

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