Hillsboro Vision Clinic
503-648-5522
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Patient Forms

Personal_and_Medical_History_Questionnairerevised12-2014_mu.pdf
File Size: 279 kb
File Type: pdf
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This is our personal contact and insurance information form.  We will need this information to enter you in our system and to bill insurance if it is available.  Your medical history is also requested so we can take these conditions into account while examining your eyes and visual system.
Contact Us
5317 E Main St.
Hillsboro, OR 97123
Phone: 503-648-5522
Office Hours
Mon    9:00 am - 8:00 pm
Tue     9:00 am - 8:00 pm
Wed    7:00 am - 8:00 pm
Thu     9:00 am - 8:00 pm
Fri       9:00 am - 5:30 pm
Sat      9:00 am - 1:00 pm
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Notice of Privacy Practices
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