Thank you for choosing Busby Eye Care!
Please take a few moments to gather some information before your visit to our office.
Forms to Complete In order to provide you with the best possible care, please complete, sign and date the following documents prior to your visit. The print version is available to print, complete, and bring to the office on the day of your appointment. To expedite your visit, the online version is available to be sent via text or email and will be submitted safely and securely to our office. Thank you for your time.
- Printable Forms
- HIPAA Privacy Notification and Acknowledgement Form – print version
- Appointment Policy – print version
- Busby Eye Care Financial Policy – print version
- Records Release Form – print version
- Infant SEE Questionnaire – print version
- Sports Vision Questionnaire – print version
Items to bring to your visit:
- Any glasses, sunglasses, contact lenses, and contact lens boxes
- Medical and/or vision insurance card
- Prior eye care records
- You can either bring these documents with you or have your previous doctor fax them to our office at (317) 896-5335
- Completed Patient History, Busby Eye Care Financial Policy and HIPAA forms