Patient Resources Forms

Patient Forms & Resources

Charges, Billing and Insurance

When you come to the office, please bring your insurance(s) cards. It is our policy to collect your co-payment/deductible or payment in full for services not covered by your insurance at the time of your visit. For your convenience we accept cash, check Visa, MasterCard, American Express and Discover.
You may also pay your bills online here

Cancellation Policy

If you are unable to keep an appointment, we ask that you kindly provide us with a least a 24 hour notice. This courtesy on your part, will allow us to accommodate another patient who could benefit from an appointment. Please call our office at (563) 588-4675.


Sometimes it is necessary to dilate the eyes to complete your eye exam. Plan on bringing a pair of sunglasses as your eyes may be sensitive to light if they are dilated. We also offer disposable sunglasses if you forget to bring yours.