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Dr. Jonathan Chua, M.D., Ph.D., F.A.C.S., General Ophthalmology Barry A. Schechter, M.D., F.A.A.O., Refractive Cataract Surgery, Glaucoma, Cornea & External Disease Specialist Lee S. Friedman, M.D., Pediatric Ophthalmology, ROP & Adult Strabismus Randy S. Katz, M.D., Retinal Specialist, Vitreo-Retina, Diabetic Retinopathy, Retinal Detachment & Macular Degeneration Specialist Jason J. Gorscak, M.D., Refractive Cataract Surgery, Glaucoma & Comprehensive Ophthalmologic Care Peter A. D. Rubin, M.D., F.A.C.S., Ophthalmic Plastics & Orbital Surgery

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Forms

New Patient Forms

This page provides forms for new patients. For your convenience, you may download them from here to complete prior to your visit. Simply bring the completed form with you at your scheduled appointment.

New Patient Adult Form (click to download)

New Patient and Medical History
Refraction Policy
Consent Form - HIPAA
HIPAA Notice
Records Release

New Patient Child Form (click to download)

New Patient and Medical History
Refraction Policy
Consent Form - HIPAA
HIPAA Notice
Records Release

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All of the clinical and research information provided on this website is intended for educational and communication purposes only and is by no means intended to replace actual medical care. Florida Eye disclaims any and all liability for injury or other damages that could result from the use of information obtained from this site.