Marc S. Simmons, O.D., Inc.

		Home
		Our Practice
		Our Services
		Promotions
		Patient Forms
		Eye Care Articles
		Order Contact Lenses
		Visual Field Analysis
		Fundus Photography

Patient Forms

INSTRUCTIONS

Please download and complete patient history form and Receipt of Notice of Privacy Policies & Consent Form prior to your visit. You can view Privacy Policy by clicking on the Notice of Privacy Practices link below. Thank you.

Privacy Form

History Form

These PDFs require a free plugin that may have come included with your browser. If you are having difficulties opening these files Click Here to go to Adobe's web site for Adobe's PDF reader.

Notice of Privacy Practices