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Harmony EyeCare
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(812) 423-4984

Forms

Each form can be filled out on your computer. After filling out, please print and sign by hand.

  • Patient History Form
  • Patient History Form
  • Records Release Form
  • Records Release Form
  • HIPAA Form
  • Authorization to discuss your information
  • Patient education sheets on various topics
  • Dry Eye
  • Glaucoma
  • Macular Degeneration
  • Diabetic Retinopathy