Eye Emergency? Schedule An Appointment (opens in a new tab) Pay My Bill (opens in a new tab) Patient Portal (opens in a new tab) Give Boling Vision Center a phone call at (574) 200-6359
Give Boling Vision Center a phone call at (574) 200-6359 Contact Us

Your Forms, Ready When You Are

Whether you're a new patient completing registration for the first time or returning to update your information, our patient forms are available here for convenient download and completion before your visit. If you're unable to complete forms in advance, please plan to arrive 15 minutes early to allow time for in-office completion.

If you have questions about any form or need assistance completing it, our team is happy to help. Call any of our four Northern Indiana locations before your appointment.

Registration Forms

New patient registration forms gather the information our team needs to provide safe, accurate, and coordinated care from your very first visit. This includes personal and contact information, medical and ocular history, current medications, insurance details, and emergency contact information.

HIPAA Privacy Notices

Boling Vision Center is committed to protecting the privacy and security of your personal health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA). Our Notice of Privacy Practices describes how your health information may be used and disclosed, and how you can access that information.

We ask that all new patients review and acknowledge our HIPAA privacy notice as part of the registration process.

Questions?

If you have questions about any of our forms or our privacy practices, please don't hesitate to reach out. Call any of our four Northern Indiana locations, and our team will be glad to assist.

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Amazing Happens Here

Three generations. One unwavering standard.

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Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at (574) 293-3545.
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