Get Triage Form New Patient - Welcome To Bright Eyes

Completing the Triage Form for new patients at Bright Eyes is a straightforward process designed to gather essential information for your eye care. This guide will provide you with clear instructions to help you fill out the form online efficiently and accurately.

Follow the steps to complete the Triage Form with ease.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin with the patient information section. Enter today's date, last name, first name, and middle initial. Fill in your address, city, state, and zip code.
3. Provide your contact information by filling in your home phone and cell phone numbers. Specify your gender and date of birth.
4. Indicate your eye history. Answer whether you wear prescription glasses or contact lenses. If applicable, include the type of contact lenses you use and any solutions.
5. Describe the issue you're experiencing with your eyes, specifying if it concerns your right eye, left eye, or both. Include details on the symptoms, how the problem began, and when you first noticed it.
6. Complete your medical history section by providing your primary physician's name, location, and the date of your last physical exam. List any current medications and allergies, along with any past surgeries.
7. Review the questions regarding family medical history and check all that apply. This includes conditions such as diabetes, heart disease, and other health problems.
8. Fill out the authorization to release information and consent for treatment sections by signing and dating where required.
9. Lastly, review the patient payment responsibility information. Ensure you understand the payment policies before finalizing your submission.
10. Once all sections are completed, save any changes, and then download, print, or share the form as necessary.

Complete your Triage Form online today to ensure a smooth visit at Bright Eyes.