Welcome to
Vision Center of Delaware

Give us a call today!
302-737-5777


Press the "New Patients Form" link below and  print.



New Patients Form

 
 

The Day of your Appt.  What to expect.


  • The completed New Patient  forms
  • A list of all medications and eye drops that you are currently taking
  • Any contact lenses or glasses that you currently wear
  • Your current insurance cards including Medical Insurance card
  •  For a Comprehensive Eye exam Co-pays expected at time of visit and Medical Eye Exam Co-pays for specialists         as noted on your insurance card
  • Referrals from your primary care physician if your insurance requires a referral to see a specialist. (NOTE:         Without a proper referral, payment will be due at the time of the office visit.)
  • A valid picture identification card
  • New Patients will be dilated for the Exam.  Make sure you bring sunglasses and if needed a driver.

 
 
 
 


Requesting Medical Records


Your records will be released to you upon receipt and Payment of the 

signed Medical Record Release form.


You can request records from Vision Center of Delaware by,


  • Mail the completed form to Vision Center of DE office.

  • Fax or Email the completed form to Vision Center of DE office.

  • Bring in the completed form to Vision Center of DE office.


Processing Cost

$15.00  Please allow up to 10 days to process your request.


Authorization Signature for Your Records Release

By law, the following authorized people are able to sign for the release of your health information:


  • Yourself  (not your spouse)

  • A parent (for patients younger than 18 years of age)

  • Legal guardian (guardianship documentation is required)

  • Power of attorney if patient is unable to sign (legal documentation is required)

  • Estate representative for a deceased patient (estate documentation is required)

  •  Click Link to Print:   Record Release form


These parameters follow Delaware State laws. 
Board of Medical Licensure and Discipline Section 16.0
 
 

Patient Feedback Form 


We would like to extend this opportunity to you by providing feedback to us in an effort to improve on our services.  Your information will be kept confidential and you will only be contacted if you desire us to do so.  Thank you for taking the time to fill this questionnaire out and allowing us the opportunity to serve you better. 

Thank you for contacting us. We will get back to you as soon as possible
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