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Online Bill Payment
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Patient Forms
You may print registration forms and bring them in filled out if you would like. Please fill all forms out completely.
Also please bring in all Insurance Cards and
let us know if you may have Vision Benefits.
| DEMOGRAPHICS.PDF |
| MEDICAL HISTORY.PDF |
| HIPAA.PDF |
| PRIVACY PRACTICES NOTICE |
We are Medicare participating providers. We also accept most major commercial medical insurances. We are Vision Service Plan (VSP) providers. Dr. Maynard also accepts some Davis Vision and EYEMED plans. Please verify that we participate with your particular insurance or vision plan. If we are not in your plan, you may have an option to file an out of network form and reimbursed yourself. If you have an HMO, you are responsible to obtain a referral prior to your appointment. We accept payment by cash, check or credit card.
