Patient Forms

Please print and fill out these New Patient forms so we can expedite your first visit.

New Patient Forms

Authorization form to Request Medical Records from another practice

Authorization form to Release Medical Records from Carolina Retina Institute 
 

First Visit to Our Office

  • Contact your Primary Care Physician for a referral to see a specialist if required by your insurance
  • Be at the office 20 mins before your appointment, if you are unable to print and fill out your New Parent form prior to coming in
  • Bring your current glasses and a list of your current medications
  • Bring your Insurance card and your Driver’s License as we will need to make a copy of it to bill your insurance company for our services
  • Expect to be at our office for approximately 2 hours for a complete exam.
  • Your eyes will be dilated during your exam. This can make driving difficult for some patients. You might wish to bring along a relative or friend who can drive you back.
  • If, for any reason, you cannot keep a scheduled appointment or will be delayed, please call as soon as possible. There will be a charge of $25 for all No Shows or Appointments canceled less than 24 hours of appointment date.

Driving Directions to Carolina Retina Institute:

Please follow the directions below to avoid getting lost in the Professional Parkway Medical Plaza.  There are about 30 Medical Practices in the office complex. 

If coming from Raleigh:

  1. Take U.S. 1 and take exit 99 for Cary Parkway
  2. Keep left at the fork to continue toward SE Cary Pkwy and
  3. Turn left onto SE Cary Pkwy
  4. We are located in the Parkway Professional Park Office Complex.  Beige Buildings on your Right Hand Side
  5. Take the 3rd entrance into the Parkway Professional Park with the sign “Suites – 200 Upper Level & 100 Lower Level”   
  6. Make your First Left and come down the hill and around to the back of the building to Suite 100.

If coming from Apex:

  1. Take U.S. 1 and take exit 99 for Cary Parkway
  2. Keep RIGHT at the fork to continue toward SE Cary Pkwy
  3. We are located in the Parkway Professional Park Office Complex.  Beige Buildings on your Right Hand Side
  4. Take the 3rd entrance into the Parkway Professional Park with the sign “Suites – 200 Upper Level & 100 Lower Level”   
  5. Make your First Left and come down the hill and around to the back of the building to Suite 100.