1501 N US HWY 441 Bldg 1100 Ste 1106 The Villages, FL 32159
352-775-0823
203 South Seminole Avenue Inverness, FL 34452
352-794-1500

Patient Resources

Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time, as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so that you can accelerate your check-in process. Please download, print and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive to your appointment between 15-30 minutes early so that you can have ample time to fill out the appropriate forms.

Patient Referral Form

Patient Referral Form

Comprehensive Retina Consultants - Physician Patient Referral Form

Financial Policy

Financial Policy

Comprehensive Retina Consultants - Financial Policy PDF

Lifetime Insurance Information

Lifetime Insurance Information

Comprehensive Retina Consultants - Lifetime Insurance Assignment and Authorization

Medical History Form

Medical History Form

Comprehensive Retina Consultants - Medical History Form

Medication Listing

Medication Listing

Comprehensive Retina Consultants - Medication Listing

Medical Records Request

Medical Records Request

Comprehensive Retina Consultants - Medical Records Request

Privacy Notice

Privacy Notice

Comprehensive Retina Consultants - Notice of Privacy Practices

Patient Information Sheet

Patient Information Sheet

Comprehensive Retina Consultants - Patient Demographic Information Sheet

*Individual results are not guaranteed and may vary from person to person. Images may contain models.