Patient Center

Welcome to our Patient Center! Feel free to bring these forms with you for your visit or download for your records.

Important Forms

There are a few important forms that will need to be completed prior to your appointment. For your convenience, you may download and print the forms below in advance, fill them out, and bring them with you to your appointment. They can also be mailed to you in advance, or filled out in person on the day of your visit.

HIPPA Form - Download & Print
Notice of Privacy Practices - Download & Print
Review of Systems - Download & Print
Insurance Registration - Download & Print
Records Transfer Authorization to NWO - Download & Print
Records Transfer Authorization from NWO - Download & Print

Payment Options

At Northern Waters Ophthalmology, our mission is to provide quality service and products at reasonable pricing. We accept the following payment methods:

  • Cash
  • Check
  • Visa, MasterCard, American Express and Discover
  • Flexible Spending Plans
  • Health Savings Accounts (HSA)

Participating Insurances
Our practice accepts most insurance plans. Coverage may vary from one plan to the next. Please call our office to verify your benefits before your visit.