New Patient Forms Online – Retina Specialists in Connecticut

Filling out your New Patient Forms ahead of time will expedite your check-in process.

You can fill out these forms electronically by clicking the button below

You may also print the forms and bring a completed version to your appointment:

Downloadable PDF Form

What type of treatments do you offer?

Age-related Macular Degeneration

Diabetic Retinopathy

Retinal Vein Occlusion

Flashes and Floaters

Retinal Tear and Retinal Detachment

Macular Hole / Macular Pucker

Inherited Retinal Disorders

Uveitis

Ocular Tumors

Dislocated Lens

Pediatric Retina

Ocular Trauma

Affiliations & Memberships

Hartford HealthCare

UCONN School of Medicine

Connecticut Children Medical Centre

Trinity Health Of New England

Eastern Connecticut Health Network

Quinnipiac University

Awards and Recognitions

Top U.S. News Doctor

Best Doctors

Castle Cannoly

Consumers' Research Council of America (CRCA)

Success Stories

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