Policies & Medical Forms

Medical Forms

Save time by filling out these forms in advance of your first visit.

General Forms

Download our patient information packet, medical forms, and privacy policy by clicking the links below.

Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by Clicking Here.

Cancellation Policy

Cates Family Eye Care asks that you please give 24 hours notice if you find the need to cancel your appointment. We will work to get you rescheduled in the shortest amount of time possible.

Financial Policy

Co-payments are fees not covered by your insurance and are due upon date of service. We will file claims for services rendered to the appropriate insurance payer in good faith. All medical eye care is subject to any insurance deductible. It is the patient’s responsibility to know the specifics of the insurance plan and to pay any amounts applied to the patients deductible. and /or co-insurance for non-covered items. A minimum 50% down payment on custom and special order materials is required to start your order. Any balance will be due upon dispensing of your eye wear. Unpaid balances are subject to monthly late fees and additional services fees if sent to collections. NO cash refunds on materials. Cancelled orders and returns are subject to penalty fees of up to 50% of original invoice. Materials will be sent back 30 days after notification they have been received by our office and any money paid will be forfeited.