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Patient Forms

We want to thank you for choosing Bluffton Family Eye Care for all of your eye care needs.
To help us deliver the best possible service, please bring the following with you to your
appointment:

• The Patient History form.
• The HIPAA form, signed and dated.
• A list of current medications.

For contact lens wearers:

• Any contact lens packaging that you may have.
• Explanation of Contact Lens Service Fees, signed and dated.

We look forward to seeing you soon.

Sincerely,

Matthew D. Mitchell, OD
Julayne A. Miller, OD
Michelle L. Frye, OD

Read and fill out the forms below: