Patient Exam Forms
Our Vision Center provides comprehensive medical eye care for patients of all ages. Our Board Certified Ophthalmologists, Optometrists, nursing and optical staff are ready to serve all your eye care needs. We combine our expertise with the latest technology to evaluate a vision solution that’s best for you. Whether you’re looking for eyeglasses, sunglasses, contact lenses, routine eye exams or refractive surgery, we have a variety of options to fit your needs. With two convenient locations and a friendly experienced staff you can rest assured our eye care team has you covered.
HIPAA Patient Privacy Notice
Verbal Authorization HIPAA Form
Patient Financial Policy
New Patient History Form
Medical Records Release Form
Consent to Treat Minor Children
All parents/guardians must be present at first visit.
Ready to Get Started?
Friendly, Convenient Medical and Optical Vision care Delivered with Excellence
Deaconess Gateway Health Center
4233 Gateway Blvd
Newburgh, IN 47630
Deaconess Clinic Downtown
120 SE 4th St
STE# 1300
Evansville, IN 47708