Insurance Information:
Providing this information to our office prior to your appointment will allow us to attempt to obtain any insurance coverage you might have. We will contact you when we have obtained verification of your vision or medical eye coverage, if any. Please be aware that some insurances require certain network providers be used, and many now have large deductibles that need to be met before any payments are made. Ultimately, you are responsible for any charges from our office not covered by insurance.
You may complete this form on your computer, or print it out and fill in the information with a pen.
Upon completion, please do one of the following:
1) Fax this form to Rahn Eyecare Center at (513) 248-1247.
2) Email this form to FormSubmit@rahneyecare.com. (Works best with Microsoft Outlook or Outlook Express)
3) Mail this form to us, if there is enough time remaining before your appointment to allow us to check into your coverage.
Thank You!!
