New England Eye Center - Laser Vision Correction

 

Forms

For your convenience, you may print and fill out necessary forms before visiting our office.

Medical Reconciliation Form

Lifestyle Questionnaire

New Patient Form

The information you provide on this patient history form will allow us to offer you the best possible care.

HIPAA Notice

This is a notice of our privacy practices.

Privacy Practice Acknowledgement

Sign this form to acknowledge that you received a copy of our privacy practices.

Patient Survey

After visiting our practice, please take a moment to fill out our patient satisfaction survey.

Patient Consent Forms - Blade-Free LASIK surgery

Patients are required to fill out and sign these forms before undergoing Blade-Free LASIK surgery.

Patient Consent Forms - PRK Surgery

Patients are required to fill out and sign these forms before undergoing PRK surgery.

Patient Consent Forms - CK Surgery

Patients are required to fill out and sign these forms before undergoing CK surgery.

Patient Consent Forms - LASIK

Patients are required to fill out and sign these forms before undergoing LASIK surgery.

Patient Consent Forms - Bi-Lateral LASIK

Patients are required to fill out and sign these forms before undergoing Bi-Lateral LASIK surgery.

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If you have questions about our practice, please contact us by filling out the form below.


Office Locations

Boston Office

260 Tremont St., 11th floor
Boston, MA 02111
Toll Free: 888-515-2745
Ph: 617-636-7800

Wellesley Office

One Washington St.,
Suite 212
Wellesley, MA 02481
Toll Free: 800-452-2084
Ph: 781-237-6770

Leominster Office

20 Commercial Road
Leominster, MA 01453
Toll Free: 800-232-2220
Ph: 978-534-6100

Map and Directions