Online Forms

At Coastal Eye Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Patient Forms

Please complete these forms, as it lets us know the history and current state of your health and information. 

Thank you! 


Privacy Policy

Download & View

Billing and Insurance Policy

Download & View

Demographics

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Patients Statements for Non-HMO Patients

Download & View

Medical History

Download & View

Non Participation With Insurance Carrier

Download & View

Notice Of Privacy Form

Download & View


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Contact Us

We look forward to hearing from you.

Locations

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Hours of Operation

Our Regular Schedule

Coastal Eye Center

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed