Patient Information

The following forms can be downloaded to your computer and brought with you to your appointment. You may also fill them out online and submit them back to our office. In order for Dr. Mahanti to provide a complete and comprehensive medical opinion it is important that he reviews all your medical information. Please be prepared to provide this information to our office along with your current medical insurance information. Below are links to our patient information forms. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

Online Patient Forms

Patient Information Packet

Downloadable Patient Forms

• Patient Information Form
• New Patient Health History
• LASIK Surgery Instructions

Note: These files are in PDF format. If you do not have Adobe^® Reader^® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.

Helpful Links

Click on the links below for additional information and resources on the following topics:

• Eyes and Vision
• LASIK and Dry Eyes
• Glaucoma
• National Eye Institute (NEI)

Accepted Insurances

We participate with Medicare and most medical insurances. Please call our office if you have any questions regarding your medical insurance.

Payment Options

For your convenience we accept the following:

• Cash/ Checks
• VISA or Mastercard
• Flexible Spending Medical Accounts through your employer.
• Insurance Plans - some insurance plans cover certain elective procedures or offer fee reductions. It is important that you discuss this with our staff.
• Chase Financing gives you the freedom to get your procedure whenever you’re ready. It’s easy to apply. With three simple steps, including an instant approval process, you can say goodbye to the waiting time and reward yourself sooner.

If you have any questions, please do not hesitate to contact our office location nearest to your home.

Financing Available

Now there's a practical, affordable way to get the care you deserve: flexible payment plans from ChaseHealthAdvance.