Patient Forms
Now you can fill-out your new patient paperwork or update your paperwork on file online!
Our online new patient paperwork makes checking-in for your first appointment quick and easy for new patients. Simply follow the directions and fill-out the forms prior to your scheduled appointment. Let us know when you check in at the front desk that you completed these forms online; instead of having to fill-out this paperwork by hand, we will simply ask you for your photo ID and insurance cards and to sign our notice of privacy practices (also referred to as our HIPAA statement) and insurance/billing policy.
Our Patient Portal is a one-stop-shop for existing patients. There, you can securely message our staff and receive replies back, you can view requested records and files (such as eyewear prescriptions), and you can update your paperwork on file before coming to your next appointment.
If you were given your temporary log-in information at your appointment, or if it is on a receipt or invoice from our office, you already have access. Once you log-in for the first time, we recommend changing your password for your security.
If you were not given your temporary log-in information, give us a call and we will be happy to give you access.
Downloadable patient forms that you can print and fill out before your next visit to Vision Source Walla Walla.
For your convenience, we have also included several downloadable forms to save you time at your next appointment if you prefer to fill-out your paperwork by hand. Simply download, print, and fill-out the “New Patient Form” and the “Review Health History Form” to bring to your appointment if you are a new patient or if it has been five (5) years or more since you were last asked to update this information. Our “Notice of Privacy Practices” is available for your reference as well. If you are wanting to have your previous exams, glasses or contacts prescriptions, or other information sent to us from a different provider, fill out the “Release of Information– Sending to VSWW” and fax it to us or bring it to your appointment. If you are wanting us to send this information to another provider, fill out the “Release of Information– Sending Somewhere Else” and fax it to us or bring it to our office.
Downloadable Forms
- New Patient Form [PDF]
- Review Health History Form [PDF]
- Notice of Privacy Practices [PDF]
- Release of Information– Sending to VSWW [PDF] Fill this out if you are sending us records, prescriptions, etc.
- Release of Information– Sending Somewhere Else [PDF] Fill this out if you are having us send records, prescriptions, etc. somewhere else.