PATIENT CONSENT FORM
PATIENT INFORMATION SHEET AND FINANCIAL POLICY
PATIENT CANCELLATION POLICY
PATIENT MEDICAL HISTORY
PHYSICIAN REFERRAL FORM
Accompanying Person Form
Office Hours and Appointments
The Colorado Retina Center is open Monday through Friday from 9 a.m. to 5 p.m. We are closed most state holidays. When you call for an appointment, we will schedule a time that is most convenient for you. Should you find you cannot keep an appointment, please contact us as soon as possible and at least 24 hours before the scheduled visit.
We are available to you 24 hours a day. Do not hesitate to call the office – (303) 893-5138 – if you think you have an emergency situation. You will be seen as quickly as possible, either at the center or, if the situation requires, in the hospital emergency department.
Your First Visit
If you are new to The Colorado Retina Center, please allow enough time prior to your first visit for registration and screening by our staff. If additional diagnostic testing is needed, it will be scheduled at your convenience. Please allow additional time, as well, if you are coming for a pre-surgical evaluation.
We ask that you:
– arrange to have someone drive you home. Your eyes will remain dilated for several hours after your exam and it will not be safe for you to drive.
– bring all current medications with you. Your doctor will want to see the medications you are taking for your eye problems and other health needs.
– bring your insurance information. This includes your insurance membership card and/or other policy information and identification.
Payment for non-insured services is expected at the end of your visit. The center accepts cash, checks, Visa and MasterCard. If you anticipate any difficulty in paying for your visit or surgery, please let us know so that we can assist you with other arrangements.
Medicare assignment is accepted. In addition, we participate in Blue Cross/Blue Shield and most major managed-care insurance programs. As a service to you, we will process your insurance forms. You do not need to complete any forms as we are linked by computer to Medicare and other insurance carriers.
Your time is valuable, and we will try our best to see you as scheduled. However, emergency situations can create delays. Should this occur during your visit, we apologize and ask for your patience. If we know in advance of your appointment that a delay is likely, we will try to reach you for rescheduling.
Due to safety regulations and as a courtesy to other patients, we ask that smokers refrain from smoking in the office and building.
Questions About Your Eyes
If you have questions concerning the health of your eyes, please give us a call. Our trained staff will be happy to provide you the information you need.