Retina Specialists

Phone: 205.933.2625

Planning A Visit

A first time visit to a physician’s practice can involve a daunting amount of paperwork prior to your meeting with the doctor. We have provided most of the required first visit paper work for you to print and complete at your convenience at home prior to your visit. Our patients have found this to be less stressful and it gives them more time for thoughtful, accurate completion. If you have questions you may call or we will assist you when you arrive. Please be sure to bring you completed copies with you to your appointment.

The information provided here and the information you share with us helps to make the most of your time with the physician.

Retina Specialists of Alabama Patient Forms and Policies

Before you start the completion of the new patient registration form, download and read our welcome letter.  Please print, complete all pages and bring to your first appointment the following four forms.

  1. Patient Information Form
  2. Medical & Ocular History Questionnaire
  3. Acknowledgment of Receipt of Notice of Privacy Practices
  4. Patient Contact Information Sheet

Please bring you insurance cards, driver’s license or photo ID, and any applicable co-pays or deductibles.

New Patient Registration Forms

Privacy Policies

Once you have read our Notice of Privacy Practices please download, print and complete the Acknowledgment of Receipt of Notice of Privacy Practices indicating you have received a copy of our Privacy Practice and do the same for the Patient Contact Information Sheet indicating the individuals, if any, with whom you authorize the practice to share your private medical information. Please bring these forms with you for your appointment.

UAB Callahan Eye Hospital Out-Patient Surgery Instructions

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