Patient Center

Click on the patient information & medical history link below, fill out the forms, and bring them with you to your first visit at our office. All of the forms are in Portable Document Format (PDF).

HIPAA INFORMATION AND CONSENT FORM

PATIENT OCULAR AND MEDICAL HISTORY FORM -English

PATIENT OCULAR AND MEDICAL HISTORY FORM - Spanish


Location
Cliffside Laser Eye and Cataract Center
663 Palisade Ave., Suite 303
Cliffside Park, NJ 07010
Phone: 201-351-0478
Fax: 201-941-5840
Office Hours

Get in touch

201-351-0478

Richard Levine, MD
663 Palisade Ave.
Suite 303
Cliffside Park, NJ 07010