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Planning A Visit

Welcome to Retina Specialists of Alabama in Montgomery, LLC.  We know that you are relying on our expertise and training to guide you in making the best decisions regarding your vision.

A first time visit to our office involves an extensive amount of paperwork to fill out prior to your meeting with the doctor. To help with this, we have provided the required initial visit paperwork for you to print and complete before your visit. We hope this will allow more time for thoughtful, accurate completion of these forms.

In preparing for your appointment please assist us with the following information:

1. Please read the “New Patient Registration Forms” section below. Print and fill out the appropriate forms to bring with you on your initial visit.
2. Please read the “Privacy Policies” section below. Print and fill out the appropriate forms to bring with you on your initial visit.
3. If you would like us to file an insurance claim on your behalf, bring all insurance cards and information to your appointment.
4. Bring a picture ID such as your driver’s license, a non-driver’s license, etc.
5. Obtain any prior authorizations required by your insurance carrier.
6. Bring all prescription medications and/or eye drops you are currently taking.

New Patient Registration Forms

Please download, print and complete both pages of the Patient Information form and Medical and Ocular History form and bring them with you to your appointment.

1. Patient Information Form
2. Medical And Ocular History Questionnaire

Privacy Policies

Once you have read our Notice of Privacy Practices, please download, print, and complete the Acknowledgment of Receipt of Notice of Privacy Practices indicating you have received a copy of our Privacy Practice.   Also, download and complete the Patient Contact Information Sheet indicating the individuals, if any, with whom you authorize the practice to share your personal health information.

1. Notice of Privacy Practices
2. Acknowledgment of Receipt of Notice of Privacy Practices
3. Patient Contact Information Sheet

Directions to Our Office

For driving directions, please visit the Where We’re Located page.