Patient Forms

New Patient Forms

If you’re a new patient, please download, print, and fill out these forms before you come to the office. This will save time and help the doctor see you promptly.

  1. New Patient Paperwork Packet
  2. HIPAA Consent:  Please read HIPAA Information prior to signing
  3. ***HIPAA Information Sheet***
  4. Authorization to Release Information Verbally (optional)

Cataract surgery

If you’re considering cataract surgery with us, look no further! For your convenience, please download and review the Cataract Information Packet for helpful information about options for your surgery; then simply download, print and fill out the Pre-Surgical Questionnaire before you come to the office for your appointment.

Referring Physician Form

Release of Medical Records

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(907) 328-2920


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Fairbanks, AK

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Text us! 907-328-2920.

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Clinic Hours

Mon-Fri: 8am – 5pm
Sat / Sun: Closed

Optical Hours

Appointment Only

Our hours are back to:
8am to 5pm Monday-Friday
Closed Saturday and Sunday

Optical is open by appointment only.

As of 5/4/2020, we are scheduling ALL types of exams, as we are no longer restricted to urgent/emergent visits only. We will gladly continue to schedule telemedicine appointments when possible and at our patient’s request. We are following state mandates and social distancing protocols, and continue to put great efforts into cleaning and sanitizing to keep our patients and community safe and healthy. Please call 907-328-2920 to schedule an appointment