WINSTON-SALEM, NC
3073 Trenwest Drive
Summit Eye Care – 1st Floor  336-765-0960
Surgery Center – 2nd Floor  336-765-0960

MOCKSVILLE, NC
1102-C Yadkinville Road
Summit Eye Care
336-751-5734

PATIENT FORMS

To expedite your visit to our office, we have included the following forms to fill out before arrival.

Patient Information
Medical vs Routine Exam

Authorization for Records Release

FAQ'S

Do I need a doctor’s referral for an appointment?
Patients can call for their own appointments and do not need a doctor’s referral to be seen at Summit Eye Care. However, patients should check with their insurance carrier to determine if their insurance contract requires a referral in order for the visit to be covered.

How soon are appointments available?
Appointment requirements will vary depending on the specialty. Timely appointments are always available for urgent problems.

Do the doctors see children?
Children age 5 and over may be seen at Summit Eye Care. For children younger than five, we can refer you to a local pediatric eye care provider.

My child is 17 or younger. Should I accompany her/him to the appointment?
Parents or guardians should accompany minors (age 17 or younger) to their appointment.

How much time will my appointment require?
The time required depends on the type of appointment. Please allow two hours for your first eye examination. If you are coming for a laser or surgery evaluation, please allow two to three hours for your examination. This amount of time is usually needed for the screening procedures, diagnostic examination, and any required pre-surgical testing. Patients who are scheduled to have their minor surgery or laser surgery performed on the same day as their evaluation should anticipate spending several hours at the clinic. This will allow time for all the necessary testing as well as the surgery.

FINANCING OPTIONS

For many people, insurance will pay for most procedures and surgeries. However, for some, the patient may be expected to pay out-of-pocket. Financial considerations alone should not be an obstacle to benefiting from the lifetime of advantages these procedures can provide. There are many options available, and we invite you to explore the following:

CareCredit
As a service to our patients, we are pleased to offer CareCredit. With CareCredit you can finance 100% of your procedure and there are no up-front costs, no annual fees, and no prepayment penalties. Click below to learn more about this service.

PATIENT RESOURCES

Anwsers to questions you have and forms needed