The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information.
If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.
Financial Policy:
Galiani Ophthalmology Associates has instituted a 2.5% service charge for credit card transactions, aligning with industry standards. Please note that American Express will no longer be accepted as a form of payment. To avoid this service charge, we encourage you to consider payment via check, money order, or cash. This advance notification is provided to enable you to select the most suitable financial method for your professional services or purchases. We appreciate your understanding in this matter.
