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Stony Brook

215 Hallock Road Suite 2

Stony Brook, NY 11790 United States

(631) 675-6909

Coram Office

3650 Rte 112, Suite 101

Coram, NY 11727 United States

(631) 732-0822

Westhampton Beach Office

200 Montauk Highway

Westhampton Beach, NY 11978 United States

(631) 283-0220

Southhold Office

44210 Route 48, Unit 1 P.O. Box 463

Southold, NY 11971 United States

(631) 765-3092

Riverhead Office

1224 Ostrander Avenue

Riverhead, NY 11901 United States

631-727-2858

Online Forms

At Sound Vision Care, Inc., we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

soundvisioncare-history-form-20140501

Patient History Form and HIPAA Consent - English

To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year.

Patient History Form and HIPAA Consent - English ( click to view )

 


soundvisioncare-covid-19-screening

 

COVID-19 Screening for Visitors

COVID-19 Screening for Visitors ( click to view )

 


soundvisioncare-cls-agreement

Contact Lens Agreement

For any patient wishing to have a Contact Lens Exam - To be completed each year.

Contact Lens Agreement ( click to view )

 


soundvisioncare-gvss-agreement-form

Gentle Vision Shaping System Agreement

For any patient in need of a Gentle Vision Shaping Exam - To be completed each year.

Gentle Vision Shaping System Agreement ( click to view )

 


soundvisioncare-amsler-home-test

Amsler Home Test

For any patient with a Macular Condition to monitor their central vision.

Amsler Home Test ( click to view )

 


soundvisioncare-notice-of-privacy-practices

Notice of Privacy Practices

Notice of Privacy Practices ( click to view )


 


soundvisioncare-spanish-history-form-20140208

Patient History Form and HIPAA Consent - Spanish

To be completed by all new patients and any patient that has not had an appointment in a year or this calendar year.

Para ser completado por todos los nuevos pacientes y cualquier paciente que no ha tenido una cita en un año o año calendario.

Patient History Form and HIPAA Consent - Spanish ( click to view )


soundvisioncare-covid-19-screening-spanish


COVID-19 Screening for Visitors - Spanish Version

COVID-19 Screening for Visitors - Spanish Version ( click to view )


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