We have combined all the necessary forms you need into one single document. Print the document and fill in the forms to ensure a seamless check-in on your next visit to Salt Lake Retina.
Download Combined Forms
Provides us with basic contact information, your insurance carrier, and an emergency contact.
Helps your doctor understand the “whole picture” of your medical health and provide the best care possible.
HIPAA consent explains our protection of your medical records and gives us consent to care for you.
Copyright © 2020 Salt Lake Retina. All Rights Reserved.