Patient Forms

WE HAVE MOVED! As of Monday, November 11, 2019, our Glastonbury Office & Optical Shop have relocated to the new Gateway Medical Office Park North at 295 Western Boulevard, Glastonbury, CT .   Our former Glastonbury office (704 Hebron Ave) is closed, effective November 6^th at 12:00 PM.

**PLEASE NOTE: Please fill out our check in form prior to your appointment by clicking the below button if you have not been to our office within the calendar year. 

Check In Form

Consulting Ophthalmologists’ new patients are required to fill out a Patient Information form, Medical History, and Medication List prior to delivery of services. For your convenience, please feel free to click on the link below to complete the necessary information online.  The information will be sent directly to our office through a secure website.

New Patient Online Registration

Prior to your next appointment, please visit our new frame gallery to view and “try on” some of the frame brands available in our Consulting Optical Shops!

Click here to view our frames!

PLEASE NOTE: 

• The submission of your online information should be completed at least 24 hours prior to your appointment.  
• Our online patient registration service is unavailable between 12:00 AM – 5:30 AM, daily for maintenance; Or if you would prefer, you can print and fill out the PDF forms to bring with you to your first office visit.
• Once you have submitted your registration, a confirmation code will appear on the screen.  Please bring this code with you to your initial visit. In the unlikely occurrence that we do not see your registration, this will allow us to re-queue it.

Please be assured that all information provided to us electronically via the online registration link is secure and protected and meets all HIPAA regulations.

Medical Records Request: 
You may print out the “Authorization for Release of Medical Records” form above and either mail, fax or email it to our Medical Records Department.