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. All new patients will be required a HIPAA Compliance Agreement and a New Patient Form. All returning patients will be required a Returning Patient Form to ensure we annually have all of your current contact and medical information. 

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.

If you would like to fill our your respective Patient Form and bring it with your to your visit, use the link below to print a copy!
Returning Patient Form
HIPAA Compliance Form
New Patient Form

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