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OPHTHALMIC CONSULTANTS OF LONG ISLAND : REGISTRATION FORM PATIENT INFORMATION Patients Name (First name Middle name Last name): Email Address: Mr - ocli 2025

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44 votes

The document is a registration form for patients at Ophthalmic Consultants of Long Island, collecting personal, insurance, and medical history information. It includes sections for patient details, responsible party information, insurance data, emergency contacts, and medical history questionnaires. The form also inquires about the patient's interest in specific ophthalmic services and how they heard about the clinic.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Patient’s Name in the designated fields for First name, Middle name, and Last name. Ensure accuracy as this information is crucial for your records.
Provide your Email Address in the specified field. This will be used for communication regarding your appointment.
Select your title (Mr., Mrs., Miss, Ms., Dr.) by checking the appropriate box.
Fill out additional personal details such as Social Security Number, City, State, and contact numbers. Make sure to include both Home and Cell phone numbers.
Complete the Responsible Party Information section if applicable. This includes entering their name, relationship to you, and contact details.
In the Insurance Information section, provide details of both Primary and Secondary insurance along with ID numbers.
Lastly, review all entered information for accuracy before submitting the form through our platform.

Start filling out your registration form today using our editor for a seamless experience!

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (102 Votes)
2009	4 Satisfied (44 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the ophthalmic consultants of Long Island?

OCLI is a renowned, multi-specialty eye care group that offers a wide range of eye care services including LASIK, cataract surgery, glaucoma diagnosis and treatment, treatment of retinal disease, and comprehensive family eye care. We currently have 32 locations on Long Island and 60 physicians.

Who is OCLI Vision?

OCLI is a world-renowned, multi-location ophthalmology practice offering eye care services. Our practitioners are some of the most respected physicians in the region, earning their reputations as esteemed innovators and complication-solvers.

Does OCLI have a patient portal?

0:00 2:43 Choose a username. And provide your full. Name. Next you will need to link your patient profileMoreChoose a username. And provide your full. Name. Next you will need to link your patient profile enter your patient ID which you will find on your confirmation.

How do I prepare for OCLI vision?

Basically, make sure that youre coming in with a clean face, with no foreign substances near your eyes. Also, please dont wear cologne or perfume on the day of the surgery or wear any unnecessary jewelry or accessories.