Call Us: (717) 393-1365
New Patients: (717) EYE-WHEZ(393-9439)
Click the link below, which doctor you are seeing, to print the form.
To save form to your computer: right click the image above and select "save link as".
Medical Release form
Notice of Privacy Practices
Patients Seeing DR. KAUFMAN
Patients Seeing DR. LOCKEY
Patients Seeing DR. TITI
Patients Seeing DR. NEJAD
To print, click on the map below for the office where you are scheduled
(Drag your mouse over the icon to view the office)