Welcome to our Patient Center. Once you have scheduled an appointment we will need some additional information. Please fill out and submit the Online Patient Registration. Also, if you have access to a printer, please print and sign the HIPAA consent form and bring it with you to your appointment.
If you prefer not to fill out and submit the Online Patient Registration and have access to a printer, you may download and print the office registration, medical health questionnaire, and HIPAA consent forms and bring them with you.
Office Registration
Download & PrintMedical Health Questionnaire
Download & PrintHIPAA Consent
Download & PrintIf you do not have access to a printer, we have printed forms available at the office.
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.
Payment Options
Polsinelli Optometry believes in providing the best value for you and your family. We have products and pricing that aims to accommodate all budgets.
We accept Cash, Personal Checks, Debit Card, American Express, Mastercard, Visa, and Discover.
*We accept flexible spending and health savings accounts!*
Insurance
We currently participate with VSP, Medicare, MetLife, Cigna, First Choice Health, Providence Health Plan, Regence BlueCross BlueShield, Spectera, PacificSource Health Plans, Eyemed, United Healthcare, Aetna, Oregon Health Plan Medicaid, Kaiser Permanente North West, BridgeSpan Health, and Asuris Northwest Health.. We are currently credentialing with multiple insurances. Please contact our office if your insurance is not listed.
