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Casanova Eye Care, APMC

Robert T. Casanova, Jr., M.D


Ophthalmology

All New Patients:



We ask that you arrive 20 minutes prior to your scheduled

appointment to allow time to fill out paperwork.


Please bring your insurance cards and also a driver's license

/photo ID.


Please bring a list of all current medications you are on,

including any eye drops.


Please keep in mind that payment is expected at the time of

service, this includes a $25.00 refraction fee (if applicable).


New patients may have their eyes dilated, so remember to

bring a pair of sunglasses.

Forms:


New patients are required to fill out the following paperwork. In order to make your visit time shorter, you may download the 5 forms below and fill them out to bring with you to your appointment.

Patient Information

Authorization

Refraction Service

HIPAA Patient Acknowledgement

Notice