If this is your first appointment please complete the new patient packet for our records.
Please consider the following for your appointment:
- Your appointment can last 2-4 hours depending upon specialized diagnostic testing and possible treatment.
- Bring a snack or lunch, especially if you are diabetic.
- Please bring a list of current medications, current providers, and available medical records.
- Due to testing and possible treatment we recommend that a driver accompany you to your appointment.
We have partnered with MediCopy to fulfill your Release of Information requests and Disability/FMLA forms. MediCopy is fully HIPAA compliant and adheres to all state and federal regulations concerning release of medical information.
Patients can request copies of their medical records at no cost, but delivery fees apply for postage, so provide an email address! Please provide an email address on the authorization to expedite the process and delivery method. Records sent via email or to another provider are complimentary. Requests are completed within two (2) business days after receipt by MediCopy.
To request your medical records please fill out one of the following authorization forms:
Forms are $30 for the first form and $15 for each additional form turned in at the same time. After payment is received, Disability/FMLA forms are completed and sent to the requestor within three business days.
If you have any questions, please contact MediCopy:
online chat: MediCopy.net | phone: 866-587-6274 | email: firstname.lastname@example.org
If you require an assistance of a service animal, please review our current policy prior to your appointment.
It is Retina Northwest’s responsibility to protect your personal health information in accordance with applicable laws. Please take a moment to download or print a copy of our privacy practices form for your records. Copies are also available at all clinic locations.