Gailmard Eye Center - Patient Forms


Gailmard Eye Center

If you are a new patient with Gailmard Eye Center, over 18 years old, please print this form, complete it and bring it with you to your appointment.

If patient is under age 18 and has not been seen before at Gailmard Eye Center, please print this form, complete it and bring it to the appointment.

Gailmard Eye Center is a Medicare provider and Medicare covers the cost of many eye care services. If you are a new patient with Gailmard Eye Center and you have Medicare, please print this form, read it, sign it and bring it with you at the time of service.


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