Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
"I was really happy with the practical knowledge and the professionalism of the entire staff and the doctor himself. Would surely recommend."
"I couldn’t be more pleased with my recent experience with Dr. Faheem Ahmed and the positive outcome of my cataract surgery. In a word, Dr. Faheem is wonderful. He is eminently qualified as an ophthalmologist and ophthalmology surgeon and is up to date on the latest technology and techniques."
"My experience with this practice has been excellent. Dr. Ahmed and his team are very accommodating and extremely professional. Dr. Ahmed takes his time and explains procedures and issues. He takes his time with patients and is very kind."
"Everyone in the office was courteous, personable, professional, and caring. Dr. Ahmed listened to my concerns, evaluated test results, diagnosed the problem, and I left his office feeling very good about the visit and the outcome."
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)