New Patient Forms

Download a New Patient Form to Save Time

NEW PATIENT FORMS

To expedite our Andover Eye check-in process, please complete your New Patient Forms now.

Are you a new Andover Eye patient?
Take care of the paperwork before you arrive at our office, and you’ll spend less time waiting to be seen.
Simply download your intake forms below.

PATIENT INFORMATION

Please verify with your insurance that the physician you are scheduled with participates with your individual plan, as well as verify your eligibility and benefits for your exam. This information is subject to change. While every effort is made to keep this list current, please verify acceptance of your insurance prior to your visit with us and please bring your current insurance card with you at the time of your visit.

  • AARP
  • Aetna
  • Allways
  • Anthem Blue Cross
  • Blue Cross Blue Shield
  • BMC Healthcare
  • CIGNA
  • Davisvision
  • EyeMed
  • Fallon
  • First Health
  • Harvard Pilgrim
  • MassHealth/Medicaid of Massachusetts
  • Medicare Advantage Plans
  • Medicare Part B
  • Multiplan
  • PHCS: Private Healthcare Systems
  • Tricare
  • Tufts
  • UMR
  • Unicare
  • United Healthcare
  • VSP: Vision Service Plan

PAYMENT INFORMATION

Co-payments or co-insurance for your insurance are to be paid in full at the time of your visit, as well as any outstanding balances that you may have. For your convenience, we accept the following methods of payments:

  • Cash
  • Check
  • American Express
  • Visa
  • Master Card
  • Discover
  • Care Credit
  • Health Savings Account debit cards