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Dr. Snipes and Associates
Dr. Snipes and Associates
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    • Home
    • About Us
      • Locations
      • Meet our Optometrist
      • Services/Contact Lenses
      • Insurance and Discounts
      • Photo Gallery
      • Our Partners
      • Privacy Policy
      • Blog
      • Career Opportunities
    • Patient Information
      • Read Before Exam
      • Online Bill Pay
      • Order Contacts
      • Contact Lens Information
      • Newest Technology
      • Online Forms
      • Recycle Center
    • Patient Eye Health
      • Dry Eye
      • Cataracts
      • Glaucoma
      • Macular Degeneration
      • Myopia Management
      • Aesthetics
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  • Home
  • About Us
    • Locations
    • Meet our Optometrist
    • Services/Contact Lenses
    • Insurance and Discounts
    • Photo Gallery
    • Our Partners
    • Privacy Policy
    • Blog
    • Career Opportunities
  • Patient Information
    • Read Before Exam
    • Online Bill Pay
    • Order Contacts
    • Contact Lens Information
    • Newest Technology
    • Online Forms
    • Recycle Center
  • Patient Eye Health
    • Dry Eye
    • Cataracts
    • Glaucoma
    • Macular Degeneration
    • Myopia Management
    • Aesthetics

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Forms Content

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Online Forms

It's important to be aware of the signature pages you'll be signing at your appointment, which include the HIPAA privacy practices, patient responsibility forms, and retinal evaluation information.

HIPAA Notice of Privacy Practices

HIPAA Privacy Practices

Patient Responsibility & LensCrafters Notice

Patient responsibility

Retinal Evaluation Information

Retinal Eval information

Online Forms for Dr. Snipes and Associates

HIPAA sign in office

Download PDF

Patient Responsibility & LensCrafters Forms

 If you are using insurance the Patient Responsibility signature must be complete. This will be done in office

Download PDF

Retinal Evaluation PLEASE READ

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Important Information

It's important to be aware of the signature pages you'll be signing at your appointment, which include the HIPAA privacy practices, patient responsibility forms, and retinal evaluation information.

Optional additional services

In addition to the Optomap retinal image, we utilize state-of-the-art technology for comprehensive retinal evaluation information. Our Optovue OCT technology produces high-resolution, cross-sectional, and three-dimensional (3D) images of the retina, optic disc, and anterior segment. This invaluable data aids your Optometrist in diagnosing and managing various ocular diseases, including glaucoma, macular degeneration, diabetes, and high blood pressure. For this advanced service, there is a fee of $14.00, and you can opt in at your appointment. Don't forget to review our HIPAA privacy practices and complete your patient responsibility forms to ensure a smooth experience.

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