Patients

Patient Forms

Authorization – Release of Records (PDF)

Patient Demographic Form (PDF)

Brief History Form (PDF)

Patient Resources

The following links provide reliable vision information for our patients.

• All About Vision
• National Eye Institute 

Payment Options

We accept Cash, Personal checks and the following credit cards:

*Visa
*MasterCard
*Discover

Insurance Plans

We partner with a variety of insurance companies to give you the most affordable eye care service possible. We currently we accept: BlueCross/BlueShield of Minnesota, BluePlus, PrimeWest Health, UCare, Preferred One, Humana, Avesis, ChampVA, Medicare, Health Partners, and EyeMed. Please ask about others if yours is not listed.

Discounts

1. Self-Pay Exam
   1. 20% off Exam
   2. Must be paid in full that day
2. 3^rd Party Insurance Discount
   1. 25% off Glasses
   2. No discount on contacts-Regular manufacturer rebates exist
   3. Members w/3^rd party eyewear plans
   4. Proof of 3^rd party plan
3. 2^nd Pair Eyewear Discount
   1. 50% off 2^nd pair of RX eyewear
   2. Must be 2 complete new sets of glasses; frame and lens
   3. Discount applied to lesser costing pair
   4. Purchased on the same day
   5. Not to be doubled up with any other promotion or discount
4. Active Military
   1. 20% off for member with active duty ID card

Please Note:  All discounts will be approved and applied only by Kelsey, Lead Optician or Cherie, Manager.