Patient Forms

Save Time on Your Next Visit

Download these forms, fill them out and bring them to your first visit to save time, and breeze through registration even faster than normal.

Patient Information Form

Basic information about you, and your insurance provider.

Medical Records Release

Allows us to request your records from another healthcare provider.

Optical Warranty

Information about what you can expect when you buy glasses from Pullman Family Eye Care.

Medical Eye vs. Vision Exams

To help maximize the benefits you’re entitled to under any medical, or vision coverage you may have.

Privacy Practices (HIPAA) and Financial Responsibility Notice

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Pullman Family Eye Care

560 SE Bishop Blvd
Pullman, WA 91163

Phone: (509) 334-3300
Fax: (509) 334-7591