Eye Care Associates Patient Info & Forms

At Eye Care Associates, we understand that your time is valuable.

To save you time, we recommend downloading and filling out our patient forms before coming in for an eye examination in Raleigh, Cary, Durham, Burlington, Wilmington or any one of our 25 locations. Having your forms completed prior to your visit will make the check-in process smooth and efficient, and allow you to relax before your scheduled appointment.

Note: Please complete one set of forms for each new or existing patient. Having accurate, up-to-date patient information will allow us to provide you with the best eye care experience possible.

Download Patient Forms

Download HIPAA Information
(Updated as of August 2013 to meet HIPAA omnibus requirements)

Contact Your Resident HIPAA Officer:

Melody Pitts
Software Manager & HIPAA Officee
7020 Six Forks Road
Lower Level
Raleigh, NC 27615
919-847-0187 x3144