UNION EYE WORKS LLC
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Patient Forms

At each visit, our patients are asked to fill out a small amount of annually required paperwork. 
Below is a QR code as well as a link to our patient forms. This will allow you to fill your forms out online and they will be sent to the office!

For new patients, select "New Patient Packet".
For returning patients, select "Returning Patient Packet".
All patients fill out "HIPAA Compliance Consent Form".
If you wear contact lenses, please also fill out the "Contact Lens Compliance Agreement".
(one is for new patients and one for returning patients)

If you would like your records released, fill out the "UEW Medical Release Form".

We are currently still asking that all patients wear a mask at all times in the office. This is a medical setting and we are taking all the steps to make sure our staff and patients stay safe. If you forget a mask, one will be provided to you upon arrival. This is not optional.



Forms Website
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UNION EYE WORKS

9 SCHOOL ST STE B1
UNIONVILLE, CT 06085
PHONE: (860)-255-7691
Fax: (860)-321-7380
Hours
Tue, Wed, Fri: 9 am - 5 pm
Thu: 9 am - 8 pm
Sat: 8 am - Noon

Appointments for exams currently only available on Tuesdays, Thursdays and Saturdays. No walk-ins.
Copyright © 2020  Website by Eyefinity
  • Home
  • About Us
  • Services
    • Eye Examinations
    • Pediatric Examinations
    • Eye Diseases & Disorders
  • Patient Forms
  • Contact Us
  • Privacy Practices