For Patients
Patient Forms
Oregon Eye Specialists, PC is grateful for the opportunity to fulfill your eye care needs! We look forward to providing you with the personalized care you deserve. In order to make your next visit with us as pleasant and efficient as possible, please take a moment before your scheduled appointment to print and complete the following patient forms:
- Patient Registration Form (recently updated) – A signed patient information form is required to bill your insurance annually for new and returning patients. Please fill out the complete left side of this form before your next visit. The columns to the right labeled second and third year appointment are reserved for future visits.
- Medical History (recently updated) – The information requested in this form better allows our physicians to care for you and must be updated annually. Please fill out the complete left side of this form before your next visit. The column to the right is reserved for future visits. Please also include with it a list of current medications.
- Eye Exams – Medical vs. Vision – Please read carefully and initial at the bottom.
- Notice to Contact Lens Wearers – If you are a contact lens wearer, please read this notice and initial at the bottom.
- Why does OES ask for my SSN and ID? – Please read carefully.
If you prefer, we also welcome you to complete these forms in our office by arriving 10-15 minutes early to your next scheduled appointment.
In some cases, Oregon Eye Specialists may need your primary care physician to share pertinent medical information with us which requires your authorization. Please fill out this Records Release Form, if applicable.
For your convenience this is our Privacy Practices Notice to read before your next visit. If you are unable to do so before arriving, hard copies are also available in our clinic.
Need Acrobat Reader?
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.
Insurance and Payments
The Oregon Eye Specialists physicians are in-network providers for most plans from the major insurances and, as a courtesy to our patients, are happy to bill primary vision and medical carriers with whom we have contracts. Any fees not covered by insurance (co-pay, deductible, co-insurance or other uncovered amount) are due at the time of service.
If you would like us to bill your insurance, simply bring your current insurance card with you to your appointment. Those major insurances accepted include, but are not limited to: Aetna, Cigna, EyeMed, Great West, Health Net, Lifewise, Medicare, ODS, PacifiCare, PacificSource, Providence Health Plans, Regence Blue Cross Blue Shield, United Healthcare and VSP. If you need further assistance or would like to confirm whether Oregon Eye Specialists accepts your plan, please call the clinic nearest you.
Some healthcare-specific financing programs are available through Care Credit.
We understand that from time to time unique financial circumstances occur. If you have a special financial situation, discuss it with your physician and together you can work toward a mutual agreement.
Questions regarding a statement you received? Our Patient Accounts Department can help!
Phone: (503) 244-1232
Fax: (503) 244-8738
patientaccts@oregoneyes.net