Patient Forms for New and Established Patients

Access our patient forms that you can fill out before your next visit to Crystal Eyecare in Red Bank.

We welcome new patients and strive to provide the best care possible. We have experienced instances in which new patients did not show up for their scheduled appointments, which has caused delays for other patients who needed to see us, and undue financial harm as we are a very small business. To help us provide the best care and accommodate as many patients as possible, we ask for at least 24 hours notice if you need to reschedule or cancel. If you fail to provide adequate notice, we will charge a $50 cancellation fee. To facilitate this, we will ask for a credit card to keep on file, but we will not charge the card until we have spoken with you or after 1 week of reaching out to you without success. We appreciate your understanding and cooperation as we strive to provide the best possible care for all of our patients. That said we’d rather see your eyeballs than the cancellation fee.

Our Forms

For New Patients Please Fill Out the Following:

For Existing Patients Please Fill Out the Following:

Welcome Back Form [PDF]
Financial Policy [PDF]