Eye Physicians of Central Florida


Patient Forms


Cataract Surgery Florida New Intraocular Lens Technology
Cataract patients now have an option to see at both near and far distances after cataract surgery! Individuals suffering from cataracts previously had only a mono-focal lens implant option after surgery. NEW multi-focal, accommodating and astigmatic correction IOL technology can now decrease dependence on glasses after surgery. These include the AcrySof® ReSTOR® IOL, Crystalens® and the AcrySof® Toric IOL. If you are seeking one of these options, please feel free to consult our staff.
Pediatric Ophthalmology
We are proud to provide excellence in pediatric eye care services with recognized leaders in Pediatric Ophthalmology. Dr. Gold, Dr. Blumenfeld and Dr. Ikeda also treat adult eye muscle disorders. If you are seeking child vision care in Florida, please make sure to contact us. Our practice has placed a unique emphasis on this type of eye care. Our pediatric eye care services in Florida include crossed eye correction, blocked tear ducts, lazy eye or amblyopia, retinopathy and children's eye exams.

Patient Forms

For NEW Patients:
Please download and print both documents.
Bring the completed documents with you to your appointment.

Adobe PDF format (.pdf)
Click here for New Patient Information Sheet
Click here for New Patient Medical History Questionnaire

For ESTABLISHED Patients:
Please download and print both documents.
Bring the completed documents with you to your appointment.

Adobe PDF format (.pdf)
Click here for Established Patient Information Update.
Click here for Established Patient Medical History Update.

Authorization To Use Or Disclose Personal Health Information:
Please Click here to download and print this document for medical records release.

Signature on File, Assignment of Benefits, Financial Agreement:
Please Click here to download and print this document.

Refraction Notice:
Please Click here to download and print this document.


 

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