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Online Forms

At Somers Eye Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Form – Required

Download & Print Form

Patient Under 18 Information Form

Download & Print Form

Notice of Privacy

Download & Print Form

HIPAA

Download & Print Form


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Locations

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Our Regular Schedule

For emergencies, our 24-hour answering service can be reached by calling our office at 816-842-2015.

Somers Eye Center

Monday:

8:30 am-5:30 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:30 pm

Thursday:

8:30 am-5:00 pm

Friday:

8:30 am-2:00 pm

Saturday:

Closed

Sunday:

Closed