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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

Online Forms

Important information regarding signature pages  you will sign at your appointment.

HIPAA Notice of Privacy Practices

HIPAA Privacy Practices

Patient Responsibility & LensCrafters Notice

Patient responsibility

Retinal Evaluation information

Retinal Eval information

HIPAA Notice of Privacy Practices

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

Important Information

 PLEASE READ

The Clarifye digital eye exam now includes Retinal Imaging using Optomap. You will not require dilation in most cases and the doctor will be able to assess the complete health of your eyes. It is standard of care for all patients at our practice and limits exposure during COVID. Without insurance the exam fee is 119.00 (under 18 is 99.00) and in most cases when using insurance it adds 39.00 (under 18 19.00) to the exam copay. 

Optional additional services

In addition to the Optomap retinal image we have state of the art technology. Optovue OCT:  OCT technology generates high-resolution, cross-sectional and three-dimensional (3D) images of the retina, optic disc and anterior segment, to give your Optometrist valuable information that aids in the diagnosis and management of a range of ocular diseases like glaucoma, macular degeneration, diabetes, high blood pressure and other ocular pathology. It is $14.00 and you can opt in at your appointment.

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