Experience RGW
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Your First Visit

How to Plan

One of the many things we do to try and make your first visit to RGW a smooth and pleasant experience is to provide you with the various medical forms to fill out in advance of your visit. There are three forms—Patient Registration, Medical History Questionnaire and Dilating Eye Drops Authorization Sheet—each of which is provided in PDF format at the bottom of this page. Please download all of the forms, fill in the necessary information, print out each completed form—and remember to bring them to your first visit to our practice.

Please bring any pertinent medical records from your referring provider and a list of all your medications and their dosages. Your identification and insurance cards are important for billing your insurance plan correctly, so please bring a copy with you. Arriving at least 15 minutes prior to your appointment will give us sufficient time to make sure your records have the important information we need.

Please allow three hours for your initial appointment as we have the ability to conduct many tests onsite. This will help us determine the health of your eye quickly. Since your eyes will be dilated during the initial examination, we also recommend you arrange to have someone drive you home if you are not using public transportation.

What to Expect

When you arrive you will be greeted by our Medical Receptionist who will ask you to complete the patient registration form and medical history questionnaire. Information regarding dilating eye drops and an explanation of our Notice of Privacy Practices will be provided to you as well. To simplify your visit, we've provided links below to all of these forms so that you can print and complete them in advance.

Your medical evaluation will begin with an ophthalmic technician talking with you to secure a more detailed medical and ocular history. Drops will then be placed in your eyes to dilate your pupils. After your pupils are dilated, one of our doctors will meet with you to examine your eyes. To evaluate the retina, vitreous and macula, the doctor will use highly sophisticated and specially-designed medical instruments. Depending on your medical condition, other special tests may be performed.

Physician Referrals

Most of our patients are referred to us by other medical professionals, but we do accept all patients with retina problems. If you have been referred to us by a physician, please bring the Gray Consult Request Form since it provides a clear explanation of your eye problems as assessed by your referring physician.

Forms You Can Fill Out in Advance

Patient Registration Form. PDF

Medical History Questionnaire. PDF

Dilating Eye Drops. PDF