Patient Forms

Access our patient forms that you can fill out before your next visit to Coos Bay Vision Center in Coos Bay.

Our Forms

• Welcome Letter [PDF]
• Patient Information Form [PDF]
• HIPPA Notice [PDF]
• Records Release for Primary Care Physician [PDF]
• Records Release for Previous Eyecare Provider [PDF]
• Contact Lens Letter [PDF]
• Notice of Privacy Practice [PDF]
• Notice of Nondiscrimination [PDF]
• The Right To Receive Communication Assistance [PDF]