Formularios de pacientes
Descargue e imprima los formularios de citas generales aquí:
Pacientes con LASIK, por favor imprima el siguiente formulario:
Planes de seguros médicos:
Si no encuentra su seguro médico o su plan de visión en la lista, llame a nuestra oficina para obtener información sobre los planes adicionales que aceptamos: 888-557-4448.
- Aetna Managed Choice
- Aetna HMO
- Aetna PPO
- Aetna US Healthcare
- Aetna US Healthcare Golden Medicare
- American Medical Life
- Americas Health Plan
- AmeriChoice**
- AmeriHealth
- Anthem Health & Life Plan
- Anthem Health Plan
- APWU (Multiplan)
- Beech Street Corp.
- Benefit Plan Administrators
- Better Health Advantage PPO
- BCBS Direct Connection
- BCBS Premier Care
- Blue Choice Blue Card PPO Deluxe
- Blue Choice POS
- Blue Choice Healtnet/Healthease
- Blue Choice Prestige
- Blue Choice Select
- Blue Choice Senior Plan
- Blue Choice Wraparound Plus
- Bronx Health Plan
- Building 32 BJ
- Cambridge Health Network
- CHUBB
- Cigna HMP
- Cigna PPO
- Community Care Network CCN
- ConnectiCare: (HIP IP or Multiplan)*
- Consumer Healt Network
- Corporate Health Admin
- Council of Carpeters
- Empire Plan (United Healthcare)
- Family Health Plus*
- First Health
- First Choice
- GEHA
- GHI
- GHI HMO Select Inc.
- Great West
- Guardian
- HealthFirst 65 Plus (Not Medicaid)*
- Healthnet / PHS
- HIP Choice Heritage
- HIP VIP
- HIP HMO
- HIP Child Health Plus
- Horizon Vista
- Human Choice Care
- Independent Health
- Island Group Administration
- JJ Newman
- Local 1199 (National Benefit Fund)
- Magnacare
- Managed Care Inc.
- Medicare
- MediChoice PPO
- MediChoice POS
- Multiplan
- NALC
- National Elevator
- New England Financial
- New York Management Health Plus
- One Health Plan
- Oxford
- Oxford Medicare
- Oxford PPO
- PHS Passport (Smart Choice) Healthnet
- PHS Charter Healthnet
- PHCS
- POMCO*
- Prudential (No: AT&T Plan) POS
- Prudential (No: AT&T Plan) PPO
- Prudential HMO
- Select Pro
- Traveler
