Pediatric Eye Exam 1 Hour - Specialty Eyecare Group 2025

1. Click ‘Get Form’ to open the Pediatric Eye Exam 1 Hour - Specialty Eyecare Group in the editor.
2. Begin by entering the patient's legal name, date of birth, and last four digits of their Social Security Number in the designated fields.
3. Fill in the address, contact numbers, email, occupation or grade, and school or employer information. Ensure all details are accurate for effective communication.
4. Complete the insurance verification section by providing the vision and medical insurance company names along with subscriber details. Remember to sign both lines before proceeding.
5. In the health history section, document any previous eye exams, medications, allergies, and developmental delays. This information is crucial for a comprehensive evaluation.
6. Review personal eye health history questions carefully and mark 'Yes' or 'No' as applicable. This helps identify any specific concerns related to your child's vision.
7. Finally, ensure that all signatures are completed at the end of the form to validate your consent and understanding of policies.

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