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Patient Forms

Vision care when you need it most

IEC’s online patient registration service saves time by providing all of the forms that both new and established patients need in one convenient and secure portal. Before your appointment, register by filling in the form completely and transmitting it to IEC.

Once registered, you can fill out New Patient forms to submit electronically. We recommend you also print out a copy to bring with you to the office. Before filling out the form, disable your browser’s pop-up blocker as it will inhibit your ability to review and print your form.

Simply bring your forms, along with your old eyewear, insurance card, and photo I.D. to your appointment.

 

Patient Online Registration Form Link

New Patient Form

HIPPA Notice Form

HIPPA Consent Form

Medical History Form


Care Credit Application

IEC makes caring for your family’s vision health easy. We’ve partnered with CareCredit to provide financing options specifically for healthcare needs such as eye exams, contact lenses, and glasses. CareCredit allows you to upgrade your glasses or contact lenses when you want to and pay for them with low monthly payments spread out over time. There are no upfront costs or pre-payment penalties.

Click here to apply.

 

Care Credit Info Form


Notice of Privacy Practices

 

Notice of Privacy Practices