Patient Forms

It is of the utmost importance that you bring in an updated list of medications you are taking. These need to be cross-referenced with any medications that the eye doctor may prescribe to make sure that there are no negative side effects.

About your upcoming appointment with Grand Ridge Eye Clinic
in. To make your visit go as smoothly as possibly, we ask that
you fill out your paperwork ahead of time. Follow the link at the end of this
message and select either the English or Spanish paperwork. It will be
downloaded as a fillable .pdf to your computer. You can fill it out via your
computer or print it out and fill it out by hand. Once done, sign the printed-out
form and bring it with you to your appointment. If you do this, you do not have
to arrive more than 5 min before your appointment time. Please download and read our Notification of Practices as well.

If you need to reschedule or cancel your appointment, please
call 509-736-0710. Thank you and we look forward to seeing you!

Your Social Security Number

We value your privacy here at Grand Ridge Eye Clinics. Medical Clinics request your SSN for the purpose of being able to collect on unpaid bills. There are only a few insurance companies that use your SSN as a form of ID, Medicare/Medicaid being the primary examples. That is being changed and you can request a new ID that does not use your SSN as your ID number. SELECT THIS LINK FOR INFORMATION ON NEW MEDICARE/MEDICAID ID.

Grand Ridge Eye Clinics will only require you to provide your SSN if your insurance company is one that requires it of us to look up your information. If you are a member of one of those insurance companies and would prefer not to provide your SSN, we completely understand and are happy to accept a cash payment and will give you the information needed to bill your own insurance. Supplying your SSN to us is completely voluntary otherwise.