Forms

We want your experience at Alabama Ophthalmology Associates to be friendly and efficient. We have included several of our most-used forms to facilitate your visit with us.

New Patient Forms

If you or your child is a new patient and would like to complete most of your paperwork before coming to the office, please complete an adult patient registration (PDF) form and an adult health history (PDF) form. Please complete the pediatric registration (PDF) and pediatric health history (PDF) forms for all patients 16 years and younger.

Medical Records Release

If you need us to send a copy of your medical records to another physician or you need a copy of your medical records, please complete the medical records release (PDF) form and fax it to us at (205) 930-9127. Please allow us 5 to 10 business days to process your request once we have received payment.

Consent for Medical Treatment

We must have consent to treat our patients. For our pediatric patients, we must obtain consent from a parent or legal guardian. If someone other than the parent or legal guardian is bringing the child to the office for treatment, please fill out the consent for medical treatment (PDF) form and send a letter signed by the parent or legal guardian with the person bringing your child for an appointment.

If the patient is in the custody of a non-parent, we must have a copy of the guardianship agreement or court order before the patient can be seen at Alabama Ophthalmology Associates.

Alabama Ophthalmology Associates' Privacy Policy

We respect your privacy. Please review our privacy policy (PDF). Please contact Dusti Hallman at
(205) 930-0700 if you have any questions.