Patient Information

Our staff will be pleased to assist you in any way possible, and all efforts will be made to accommodate your schedule.

New patients are always welcome!

To schedule an appointment, call 732-607-0555.

Patient Forms

New to our office? You may download, print and fill out our patient forms prior your first visit.

Medical History Form

Financial & Privacy Policies

Enter Your Data Online

Instead of downloading our patient forms, you may use our online patient portal to enter your data directly. With My Online Clinic, you can:

Click the button below to set up your free My Online Clinic account:

Most Major Insurance Accepted

Our office accepts most insurance plans, including Medicare. Below is a list of many accepted plans. If you don’t see your plan listed, you may contact us to find out if your plan is accepted.

If we participate with your insurance plan, all co-pays and deductibles are due at the time of service. Full payment is required at the time of service if you are receiving a non-covered service:

• Contact lens fitting
• Contact lens prescription update
• Measurement of eyeglass prescription

Financial Policy

For insurance plans in which we do not participate, we may accept assignment of insurance benefits. However, you will be responsible for any balance not paid by the insurance company.

If your insurance company has not paid your account in full within 60 days, the balance will be transferred to you. Any account with an outstanding patient balance over 90 days will be considered delinquent.

Payment

Full payment is due at time of service. We accept cash, check and the following credit cards:

  VISA  +  MasterCard  +  Discover

Delinquent accounts

Delinquent accounts (90 days past-due) will be turned over to our collection agency. Note that any collection and attorney fees will be added to the outstanding balance owed.

Cancellations

Appointments cancelled with less than 24 hours notice will result in a $25 cancellation fee.

Emergencies

If you have a medical emergency, please call our 24-hour answering service at 732-607-0555.

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