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Forms & Policies

At NECO Center for Eye Care, privacy about your health information is our priority. Our policies have been established to assist and protect patients and staff and to ensure we are HIPPA compliant.

Patient Forms 

The following forms and policies are provided to assist and protect patients and staff. They are available to view online or to download. Please note that forms that require a signature must be downloaded and signed before sending via email ( or presented at our clinics. 

Vision Therapy Forms

The following forms are provided for our patients with Vision Therapy services.  When instructed, please download, fill out the appropriate forms and bring them to your appointment. 

Adult Forms/Questionnaires:

Teenage Forms/Questionnaires

Child Forms/Questionnaires

HIPPA Privacy Rule

The HIPAA Privacy Rule (Health Insurance Portability and Accountability Act of 1996) created national standards to help protect a patient's personal health information (PHI) and medical records and how they are transmitted electronically.  NECO Center for Eye Care adheres to a strict set of practices to protect your health information and comply with HIPAA Privacy Regulations. You may download a copy of our privacy practice here. You may also view our privacy statement.

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