What's New!
Check out our info on Pediatric Ophthalmology under the Services Tab!
Fort Myers:
15640 New Hampshire Court Fort Myers, FL 33908 239-466-3111
Fort Myers:
5248 Bank Street Fort Myers, FL 33907 239-332-1990
Bonita Springs:
3940 Via Del Rey Bonita Springs, FL 34134 239-498-7666
Patient Information
Dear Patient:
Welcome to West Coast Eye Care, and thank you for selecting us for the care of your eyes. We will make every effort to satisfy your needs.
We ask that you complete the registration form below. On the day of your appointment bring any insurance cards you may have and take a note on what date you submitted this form. If you request or require a refraction to determine your current eyeglass prescription, please note that Medicare and most insurances do not cover this service. A refraction will only be performed at your request, or if the Doctor considers it medically necessary.
If you have an insurance that requires an authorization or referral form, please obtain this prior to your visit. If you are not sure if your insurance requires an authorization, we suggest you contact your insurance carrier directly for this information.
You may expect your first visit to last 60-75 minutes. The Doctor will be performing a comprehensive eye examination which requires dilation of your pupils. Dilation causes temporary blurring and light sensitivity; therefore, you may wish to have someone accompany you to drive you home.
During your visit, please feel free to ask any questions about your eyesight. Should you have any questions or concerns before your appointment, please don not hesitate to contact us. We look forward to meeting you!! It is certainly our privilage to serve you.
Sincerely,
West Coast Eye Care
Please bring a list of your medications and your glasses and/or contact lenses with you.
Payment is expected at the time of service. Please review our Financial Policy.
Considerable care has been taken in setting the fees. We want to assure you that our charges accurately reflect the complexity of care rendered and the skill and exertise required for our care.
Patients with No Insurance: Our policy requires payment in full at the time of service for all visits. Payment arrangements can be made for surgical procedures rendered in the office. Our staff will be happy to discuss with you details on setting up payment arrangements, if necessary.
Medicare patients: Our office does participate with Medicare. Therefore, if you are enrolled in Medicare part B, a claim will be filed for services rendered. Medicare will pay 80% of their allowed amount for all covered services, minus any deductible not met at the time the claim was filed. You will be responsible for the remaining 20% at the time of service, including any non-covered services and deductible not satisfied.