Patient Forms

Enclosed are registration and health forms for you to fill out. Please bring the completed forms and your insurance cards to your appointment. In addition, we will ask for a copy of your driver’s license or photo ID with your current address. 

NOTE: The below documents require Adobe® Reader® to view. If you do not have this installed on your computer, CLICK HERE to get it free.

Appointments
Office hours are 8:00 am -5:00 pm with lunch daily from 12:00 pm-1:00 pm.  If you need to cancel or change an appointment, we ask that you provide at least 24 hours’ notice.  A no show or late cancellation fee of $25 will be charged if we do not receive the requested 24 hour notice.  If you are scheduled for a complete eye exam, your eyes will likely be dilated. You may want to arrange for someone to drive you. Please bring sunglasses as your eyes will be sensitive to light. If you are a contact lens wearer, do not wear your lenses in but bring your contact lenses, as well as the prescription along with a lens box, as this will be helpful in determining your current correction. There is an extra charge for a contact lens fitting as it is not a covered charge under insurance programs. The cost will be determined at the fitting. Patients who are interested in contact lenses are scheduled with Dr. Daddario.

Medication Refills
Call your pharmacy directly to request a PRESCRIPTION REFILL. The pharmacy will contact us and we will address your request within 48 hours. If you need a written prescription for a mail in pharmacy, please provide us with the name of the medication, the dosage, and the quantity desired. Written prescriptions will be ready for pick up at our front desk at the location of your choice. We ask for 48 hours to process your request.

Insurance Authorizations 
Please be aware that some insurance companies require an authorization for you to see a specialist. It is imperative that you contact your primary care provider so that they can fax the authorization to us prior to your appointment. If you do not have a prior authorization, you may be asked to reschedule. 

Insurance 
We are participating providers with Medicare and other insurance companies. Feel free to contact our office to verify if we participate with your specific insurance company. Deductibles or co-pays will be due at the time of service. In addition, there will be a $50 charge for the refraction portion of the complete eye exam.  Medicare and other insurances consider this a non-covered service and will not pay for this very important part of your eye exam. 

If you are a Diabetic, be sure to include your current A1C numbers on the attached medical history.