top of page

Patient Forms

Patient Forms:

For your convenience, you can download forms and fill them out to bring to your scheduled appointment.

For new patients and patients who haven't been seen in more than 3 years,

please fill out Patient Registration Forms (3 pages).

Please refer to Notice of Privacy Practices.
 

 

Medical Records Request:
If you are requesting our office to release your medical records, please fill out

the Medical Records Release Form and email it to admin@kennethmortonmd.com.

We will release chart notes of your last three visits. Options are:

  1. Transfer to your new eye doctor (No records release fee will be charged.)

  2. Release to yourself (Records release fee will be charged. A processing fee of $6.50 per patient

      applies to medical records requests. Documents will be delivered via encrypted email.)

      

Please allow 5 to 7 business days for processing once we receive your medical records release request and payment (payment applies only if releasing records to yourself).

© 2018 Eastside Eye Consultants

9 Lake Bellevue Drive, Suite 105 Bellevue, WA 98005

Tel: 425-562-6135

bottom of page