For Patients

Preparing for your first appointment at NJ Retina

If you were referred to NJRetina by another physician, provide that information to the receptionist if possible, as we may be able to receive relevant medical information in advance from your referring doctor.

Be sure to let the receptionist know if you will require any special help for your visit, such as a wheelchair.

For your convenience, you can download our new patient forms below prior to your visit , complete them, print them out and fax them to us. Please tell the receptionist whether you plan to fill in and fax these forms to us. Do not worry if you’re not able to fill in every question. Our staff will work with you to fill in any gaps in your paperwork.

Typically, a patient’s first appointment takes at least 2 hours and includes a complete eye examination. During the exam, we will use eye drops to dilate your eyes, causing temporary blurred vision, so it is necessary for someone to drive you home after your appointment.

If you are uncertain about the details of your insurance coverage, our office staff will work with you to help determine and understand your coverage, including any preauthorizations required before surgical procedures.

Patient Forms

Download, fill out and bring in your patient forms on your next visit! We encourage you to fill out these patient forms prior to your visit. If you prefer, you can bring your completed forms to your first appointment or fill them in once you arrive for your appointment. If you plan to fill in your forms at the office, we recommend that you arrive 15 minutes early to your appointment.

New Patient Form (English)

New Patient Form (Spanish)

Returning Patient Form (English)

Returning Patient Form (Spanish)

Medical Records Release Form -- Physician Request

Medical Records Release Form -- Patient Request