Patient Forms

Patient Forms

Current ECA Patients
Click here to Update Your Information

Eyecare Associates’ New Patient Information Form
Click here to download PDF of Eyecare Associates’ New Patient Information Form

ECA’s Authorization for Use or Disclosure of Protected Health Information
Click here to fill out and submit online.
Click here to download PDF of ECA’s Authorization for Use or Disclosure of Protected Health Information

ECA’s Medical Records Release Form
Click here to fill out and submit online.
Click here to download PDF of ECA’s Medical Records Release Form

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