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Our Locations:
Buchanan: 269-695-3434 [Email | Map | Appointment]
New Buffalo: 269-469-6331 [Email | Map | Appointment]
Dowagiac: 269-782-7141 [Email | Map | Appointment]
Home » Online Form Page

Online Form Page

Below is a list of forms you may find helpful:

  • Medication List   Systemic medications can have ocular side effects.  For this reason it is important for us to know all of the medications you take, including the dosage and route.  Some insurances, such as Medicare, require us to have this as part of your record to obtain reimbursement for the services we provide you. 

          Please print this form and complete prior to your appointment to allow us to serve you most efficiently when you arrive at out office.