863-294-CFEC (2332)
122 East Central Avenue
Winter Haven, FL 33880

 

863-294-CFEC (2332)
Patient Forms

Introducing EyeScience
Eye
Vitamins



EyeScience Macular Health Formula(TM) is the most complete eye vitamin supplement specifically for AMD. Based on more than two decades of ocular research, EyeScience Macular Health Formula(TM) contains 14 clinically proven nutrients to support a healthy retina, including omega-3, lutein, zeaxanthin, bilberry, grape seed extract, selenium, L-glutathione and alpha lipoic acid.
source eyescience.com

Now available in our office.

For an appointment please call our office at
 863-294-2332
or
contact us by email.

Download patient forms for your convenience.

New Patient Forms

To make your first check in with us go as quickly as possible, please print and complete the following forms prior to you visit.



    Welcome Letter/New Patient Checklist

    
Patient Information or Patient Information- Spanish

    Notice of Privacy Practices

    Patient Consent for Release of Information

    
Financial Policy


Request for Release of Medical Records

Use this form to request your medical records to be sent to our office from your referring doctor.


    Request for Release of Medical Records


Directions
Map and directions to our office from surrounding areas.


    Directions to Central Florida Eye Care

 

The above forms are in the Adobe Acrobat® PDF format. To download a free copy Adobe Reader® click on the link below to go to the Adobe web site. 




We look forward to welcoming you to our Central Florida Eye Care Family.