Appointment and Registration Forms

Please fill out the following forms online to prepare for your appointment ahead of time. Please bring all of your insurance cards with you to your appointment.

1. Privacy Policy Acknowledgment
2. Financial Policy
3. Patient Registration
4. Confidential Medical History

Insurance & Financial Information

New!    Now you can pay online using our secure online payment - click here.

Mirate Eye Center participates in the following insurance plans. If you see your insurance company below, you can call the toll-free number or click the link to see whether our services are covered under your benefits.

Questions? For questions about your Mirate Eye Center billing statement, please call our insurance specialists at 866-728-8401, Monday – Friday from 9 a.m. until 6 p.m.