Printable Forms/Welcome packets 

Please read all the material so you will be educated about your visit and prepared with questions for Dr. Affleck.  

Please print and complete the forms.  Do not leave anything blank.  This information is important to your treatment and insurance coverage.

If you are unable to print the forms, 
 we will have one available for you to pick up before your appointment or waiting for you when you arrive for your appointment.  

The type of "Welcome Packet" you will recieve will depend on the type of appointment. If you are having your cataracts evaluated select the documents under "Welcome Packet for all patients with cataracts"   All other patients will select the documents and forms under "Welcome Packet."


The Welcome Packets have three sections: Reading Material, Information Forms and Check off list.  Carefully follow all directions!   


 

Affleck eye care patient intake

Welcome Packet 

Click here to print Affleck, MD Eye Care Patient forms that need to be fill out for your visit

Click here to read important information about your visit

Click here for a check off list of what to bring to your appointment

 

Welcome Packet for all patients with cataracts

Click here to print Affleck MD Eye Care Cataract Patient forms that need to be fill out for your visit and evlauation for cataracts

Click here to read important information about your visit and cataracts

Click here to read patient education on cataracts

Click here to read about RESTOR or Click here to read about TORIC advanced lenses to replace your cataracts

Click here for a check off list of what to bring to your appointment

     
   
   


 



Other Printable forms:

Click here to print "LASIK patient information sheet for Affleck MD Eye Care"

Click here to print "Worksheet for common questions asked at an eye exam"

Click here to print "Map, Directions & Photo of Office at 2900 Valencia Drive"