Patient Center

Welcome to our Online Patient Center! Here you can get information about what to expect during your visit with our team as well as important forms you can complete before your appointment to save time.

We want your visit to be as stress-free as possible. Our staff will do everything we can to make sure your experience is pleasant and convenient. If you have any questions about these forms, please don’t hesitate to contact us.

What to Expect

When you visit our office, you will be warmly welcomed and we can answer any questions you may have about completing the paperwork so that Yakima Eye Specialists may see you. Our team will work together to evaluate your eyes and provide relevant eye care treatment information and focus on exceeding all of your expectations. If at any time you have questions about the process or your specific health information, please ask.

Patient Forms

Please download and fill out each of the following forms. HIPAA Notice of Privacy Practices is required 

English New Patient Form

Spanish New Patient Form

English Notice of Privacy Practices

Spanish Notice of Privacy Practices

Don’t forget to use your:

• Flexible Spending Plans
• Health Savings Accounts (HSA)
• Medical Savings Accounts (MSA)
• Cafeteria Plans for most of your eye care needs

Insured by Medicare

• You must have Medicare Part B coverage in order for them to cover your medical eye examination.
• Medicare requires patients to pay an annual deductible. The deductible amount changes annually and must be satisfied before they will pay the customary 80%.
• Medicare does not cover any vision services such as a vision eye examination, refractions or contact lens fittings. Because these services are non-covered they will be collected at the time of service.
• Those patients with secondary coverage all service non-covered by Medicare are collected upfront as the most secondary payers to not cover these services either. In the case that they do pay we will issue a refund to you.