McElhinney Eye Care, PA

1004 Carondelet Drive, Suite 405

Kansas City, MO 64114

816-943-1123

info@aokc1.com

  • Facebook
dbalogoUPDATE.png

New Patient Forms

Associated Ophthalmologists of Kansas City, PC

New Patient Checklist

 

Please print, complete front and back and sign all forms.  If you have not completed the forms, please arrive 15 minutes early.

 

Bring the following on the day of your examination:

  • Completed and signed forms that you have received.

  • Current insurance cards. If your health insurance requires a specialist co-pay or if you have not met your deductible, we will collect this at the time of your visit.  We accept Visa, Mastercard, Discover and American Express.

  • Driver’s license or picture i.d.

  • A list of all medications and supplements you are taking, including strengths, dosages, and the reason you are taking them

  • Current pair of eyeglasses

 

Your eyes may be dilated to allow a complete examination by your doctor.  This could impair your near vision.

 

Please plan to spend approximately one to two hours with us for your comprehensive eye exam.

 

If you need to change or reschedule your appointment for any reason, please provide at least 24 hours notice.

Download All Forms

or

Download Individual Forms

McElhinney Eye Care, PA

New Patient Checklist

 

Please print, complete front and back and sign all forms. Please bring the following on the day of your examination:

 

  • The registration forms you have received.  Please complete all forms, front and back.  Please arrive 20 minutes early if you have not completed the forms.

  • Your current insurance cards. If your health insurance requires a specialist co-pay or if you have not met your deductible, we will collect this at the time of your visit.  We accept Visa, Mastercard, Discover and American Express.

  • Your driver’s license or picture i.d.

  • Please bring a list of all medications and supplements you are taking, including strengths, dosages, and the reason you are taking them.

  • Please bring your current pair of eyeglasses or contacts. 

  • If you currently wear contacts, we will need your most recent contact lens prescription, and/or contact lens boxes.

 

Please arrive 15 minutes prior to your scheduled appointment.  This will give our staff time to update your current information.

 

Your eyes may be dilated to allow a complete examination by your doctor.  This could impair your near vision.

Please plan to spend approximately one to two hours with us for your comprehensive eye exam.

 

If you need to change or reschedule your appointment for any reason, 24 hours’ notice would be appreciated.

Download All Forms

or

Download Individual Forms