New Patient Forms

Download and print the New Patient Forms. Fill in your details and bring it along on your appointment. If you are unable to fill out the forms prior to your appointment, arrive at the office 15 minutes prior to your appointment time.

Additional Forms

Authorization form to Request Medical Records from another practice

Authorization form to Release Medical Records from Carolina Retina Institute

We Provide the highest level of satisfaction care & services to our patients.

First Visit to Our Office

  • Contact your Primary Care Physician for a referral to see a specialist if required by your insurance.
  • Be at the office 20 mins before your appointment, if you are unable to print and fill out your New Parent form prior to coming in.
  • Bring your current glasses and a list of your current medications.
  • Bring your Insurance card and your Driver’s License as we will need to make a copy of it to bill your insurance company for our services.
  • Expect to be at our office for approximately 2 hours for a complete exam.
  • Your eyes will be dilated during your exam. This can make driving difficult for some. patients. You might wish to bring along a relative or friend who can drive you back.
  • If, for any reason, you cannot keep a scheduled appointment or will be delayed, please call as soon as possible. There will be a charge of $25 for all No Shows or Appointments canceled less than 24 hours of appointment date.