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Patient Forms



Patient Forms

signing_forms_220x229At Horizon Eye Care, personalized care is our standard. To streamline your experience, we have assembled the forms most commonly requested by new and current patients. Please complete them at your convenience before your visit, so that we may process your information efficiently. If you need medical records, appropriate request forms are also provided.

If you have any questions about these forms or our Patient Privacy Policy, please call 704-365-0555. We look forward to serving you.

New Patient Forms

To speed up the check-in process, please print out and complete the forms which have been combined into a single PDF file below and bring them to your first appointment. At the bottom of this page you will also see a link to our Patient Privacy form for your review.

Download the New Patient Forms document (.pdf)

Medical Records Release Form

Giving patients easy access to their health records is important to Horizon Eye Care. To get copies of your records, patients may print out and complete the attached PDF. This form may be dropped off at one of our six convenient locations, or FAX it to 704-405-4093. Should you have questions, please call 704-405-4108.

Download the Medical Record Release form (.pdf)

Patient Privacy

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your healthcare information is important to us.

Download the Patient Privacy Policy (.pdf)

You will need software that opens PDF documents installed on your computer in order to view these files. For your convenience, we have provided the link below to download the free Adobe Reader software.
Get Adobe Acrobat Reader

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