Vision Library

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Patient Forms

Welcome To Our Office Form – ALL PATIENTS

Open Form

HIPAA Notice of Privacy Practices – ALL PATIENTS

Open FormSubmit form online

Medicare Contract‏ – ALL PATIENTS

Open FormSubmit form online

Directions – ALL PATIENTS

Open Form

Children’s History Form – K Grade through College

Open FormSubmit form online

Teacher Assessment Form – with Children’s History

Open FormSubmit form online

Adult History Form

Open FormSubmit form online

Infant & Toddler History Form – Birth to School Age

Open FormSubmit form online

Weekly Homework Log – VT PATIENTS

Open Form

Wellness Policies – VT PATIENTS

Open Form

 

Required Forms For New Patients:

1) Medicare Contract
2) HIPAA Notice of Privacy Practices
3) One of the History Forms (Infant, Child or Adult).

Optional: Teacher Assessment Form

 

 

 

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