Patient Forms


 

Below you will find forms for our eye care patients for both our Woodstock Virginia Ophthalmologist Office and Winchester Virginia Ophthalmologist Office. These are downloadable for your convenience. Please fill out these forms prior to your appointment to make your visit swift and convenient.

Please click here to download Patient Forms if you are a patient of Dr. Hynes.

Dr. Hynes' Patients forms

Uveitis Questionnaire

Please click here to download Patient Forms if you are a patient of Dr. Seager.

Dr. Seager's Pediatric Patient Forms

en español


For Individual Forms:

History and Intake Form

Patient Registration Form

Authorization of Insurance Form

HIPPA Patient Notification Form

Financial Policy Form

Don’t let another day go by without getting a comprehensive eye exam from an Ophthalmologist to discover if you need a vision care plan, surgery or other treatments.

We have two convenient locations:103 W. South St. Woodstock, VA 22664 and 158 Front Royal Pike Suite 303 Winchester, VA 22602.

Dr. Hynes is ready to see you. Please call 540-409-5254 or 800-381-1186 to schedule your appointment today.

Our Locations

Choose your preferred location