CORONAVIRUS (COVID-19) UPDATE

We are open for all eye care needs. Please note: ALL PATIENTS ARE REQUIRED TO WEAR MASKS.
Patients will be screened for exposure and have their temperatures taken prior to entering the building.
*Patients who have traveled during the two weeks prior to appointments must bring a copy of their negative COVID-19 test results.*
Click HERE to learn more about how we are keeping you and our staff safe.

New Patient Registration

Healthy Eye, Healthy I™

At The Eye Institute for Medicine & Surgery, we are dedicated to compassionate patient care, top-notch education and delivering excellence in eye care to every patient in the Space Coast. Please take a few moments to complete the registration process.

*STEP 1*

Complete Online Registration Form

  • Complete the following Registration Form at least 2 full business days prior to your appointment date. You will need your medication list, medical history and insurance cards available.
  • If you are unable to complete the online registration, you may be asked to reschedule.

*STEP 2*

Register For The Portal

  • Register for your online portal account here: My Online Clinic (You will use this account to view your upcoming appointments, view medical history summaries, request refills, communicate with your doctor and pay bills.)
  • Take a few moments to review our Notice of Privacy Practices.

*STEP 3*

Preparing For Your Appointment

  • Bring the following items on the day of your examination:
    • A driver’s license or other government issued picture identification
    • All health insurance and vision plan coverage cards – primary & secondary
    • Any paperwork you may have from a physician or other healthcare provider who requested a consultation, or who referred you to our office;
    • A copy of your medical records from your previous eye care provider(s).
    • A means of making payment for the services you receive, including copayments, coinsurance, deductible and services not covered by insurance.
  • Be prepared to:
    • Show all of your insurance cards, state issued photo identification, sign all consents and help our staff serve you by verifying all demographic information, including your address and telephone number.
    • Provide us with your e-mail address. This will enable us to send appointment reminders, educational messages or other offers that may be of interest to you, and will help you to obtain summaries of the services you receive at The Eye Institute. Please note that new Federal Regulations require that we obtain this information.
    • Pay your copayment, deductible and any outstanding balances on the day of your appointment. Generally, all known fees will be collected at the time of check-in, however, it may take weeks for your insurance plan to process your claim and determine what additional portion of the charges they will pay for and what portion is your responsibility. Insurance companies determine the copayments, deductibles and other fees that providers are required to collect. Federal laws also require that our office collect copayments and deductibles determined to be the patient’s responsibility by Medicare.
    • Please note that contact lens fitting fees & refraction fees are generally not covered by insurances.
      Unless you have vision plan coverage that our billing staff determines will likely cover these services, payment will be requested on the day of your visit.
      NOTE: Refraction is the term used to describe the test taken to determine your eyeglass or contact lens prescription.

Downloadable Forms