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Patient Intake Form

Upon arrival for your appointment, all patients are requested to complete the Patient & Health History Form and the HIPAA Authorization Form. You are encouraged to fill-out the forms online, or download the forms, complete them, and bring them to your appointment. Start here »

Appointment Checklist

Download the appointment checklist to ensure you are prepared for your visit.

Request for Release of Healthcare Information

To have your most recent examination records and prescription released to Eye Carumba Optometry, please complete a Request for Release of Healthcare Information Form. Fill-out the form online or download the form, complete it, and bring it to your appointment. Start here »

Cancellation Policy: Cancellations less than 24 business hours prior to your scheduled appointment will be charged a $50 cancellation fee. This is an out-of-pocket fee that will not be paid by your insurance. For questions, please direct your messages to: Staff@EyeCarumba.com

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