• 12 Fairfax St. SE, Off of Catoctin Circle Leesburg, VA
  • Mon through Fri: Opens @ 9AM, SAT: 9-12:30

Faq

Faq

We are pleased to welcome new patients to our practice!
All patients please review our Notice of Privacy Practices & the Optomap Description
For Non-Medicare Patients:
NEW PATIENTS:
For your convenience you can print and complete the following Patient Information Forms to bring with you to your appointment:
Welcome Form
HIPPA Form
Insurance and Communication Consent
Electronic Medical Records Info.
Medical History Questionnaire
Optomap Retinal Consent
RETURNING PATIENTS:
Patient Confirmation of HIPPA
Insurance and Communication Consent
Electronic Medical Records Info.
For Medicare Patients:
NEW PATIENTS:
For your convenience you can print and complete the following Patient Information Forms to bring with you to your appointment:
Patient Confirmation of HIPPA
Insurance and Communication Consent
Electronic Medical Records Info.
Medical History Questionnaire
Advance Beneficiary Notice of Non-coverage
RETURNING PATIENTS:
Patient Confirmation of HIPPA
Insurance and Communication Consent
Electronic Medical Records Info.
Advance Beneficiary Notice of Non-coverage
Insurance Information
We accept many eye insurance plans, including VSP. If we don’t take your insurance, we’ll help you file for reimbursement. Eye care services and products also qualify for your flexible spending account. There are so many plans available, please give us a call to discuss yours.
Practice Policies
Thank you for choosing Eyecare Center of Leesburg for your eye care. We strive to provide the best services and quality care possible. We also strive to have the same level of quality when billing for our services. This guide will serve to assist in getting your services paid:
Practice Policies