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Patient Forms

New Patients


If this is your first time coming to our office, there will be some forms that must be filled out. Please save yourself some time by printing and completing the forms below and plan on bringing them to your first appointment along with your insurance card. Please arrive 15 minutes prior to your appointment. 

Routine Waiver Form
Health History Form

HIPAA Privacy Policy
Optional Form

Existing Patients

If you are a patient who has been to our office before, the following forms are required once a year.

Please bring the following forms to your yearly appointment along with your insurance card. Please arrive 15 minutes prior to your appointment. 

Health History Form
Patient Demographics Form (adult)
Patient Demographics Form (child)

To Request Medical Records

Please complete the Medical Records Release Authorization Form and fax it to 203-778-6238 or mail it to:

Attn: Medical Records Department
Connecticut Eye Consultants
69 Sand Pit Road
Danbury, CT 06810
Any questions, please call 203-791-2020 Ext. 268 or email

To schedule an appointment please call 203-791-2020.

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