Bailey Cove Eye Care P.C.
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Call Us To Schedule A New Patient

Patient Forms

Please complete the Personal History and Personal Information forms, print them,  and bring them to your appointment.  Complete the Records Release form if you would like us to receive past medical records from your previous doctor.  The Notice of Privacy Practices form is for you to print and/or review prior to your first appointment - it is for your records only.

Patient History Questionaire
File Size: 54 kb
File Type: pdf
Download File

Personal Information Form
File Size: 86 kb
File Type: pdf
Download File

Notice of Privacy Practices
File Size: 51 kb
File Type: pdf
Download File

Records Release Form
File Size: 53 kb
File Type: pdf
Download File

Contact: 
Phone: 256-880-3200
Email: [email protected]
​       Fax:  256-​880-1396

Office Hours:

​Monday to Friday   
​8:00 am - 5:30 pm


  • Home
  • Our Practice
    • Our Office & Location
    • Holidays & Closings
    • Social Responsibility
  • Our Services
    • Optical >
      • Neurolens
      • Lens Technology
      • Sunglasses
      • Office Lenses
      • Sports
    • Contact Lenses
    • Pediatric Vision Care >
      • Myopia Control
    • Dry Eye >
      • Blephex and iLux
      • Amniotic Membrane Treatment
    • Insurance and Care Credit
    • Technology >
      • OCT Scan
      • HD Retinal Imagining
      • Macular Degeneration Tests
  • Patient Forms
  • Schedule Appointment