PRINTABLE FORMS

The documents listed below can be printed for you to fill out at your leisure in order to be sure all your information is accurate and complete.

Please do not forget to bring your forms with you to your appointment and any other pertinent information ie x-rays, lab work, or office notes from referring physicians.

Please complete the forms in black ink!

Patient Registration Form
Patient History

The following documents are strictly for informative purposes and can be printed and kept for your files:

Notice of Privacy Practices
In Case of Errors or Inquiries about Your Bill
Patient Rights

Patient Information Booklets

Nearsightedness
Farsightedness
High Myopia
Mixed Astigmatism

Release of Healthcare Information

Individuals who have been a patient at Rocky Mountain Eye Center, P.C. have the right to access or receive copies of their medical records. Authorization for Release of Health Care Information forms can be obtained at the EYE front desk Monday through Friday, 8:00am – 5:30pm or you may print them, fill them out, and fax to (406) 541-3810 or return to our office either by mail or in-person:

Rocky Mountain Eye Center P.C.
700 W. Kent
Missoula, MT 59801

Authorization for Release of Health Care Information
 

Individuals who have an upcoming appointment at Rocky Mountain Eye Center and have records from other clinics which need to be sent to us can download that form HERE.

For our referring providers

Please fill out the following Request For Consult form and fax to us at 406-541-3810.

Request for Consult 
 

Non-Discrimination Notice 

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