New Patient Forms

These forms are provided for the convenience of new or established patients who have scheduled appointments. If you are a new patient or haven't been seen at the Spokane Eye clinic for two years or more please fill out these forms:


Patient Information Form

Health questionnaire

Release of Information—HIPAA

Friends & Family Form—HIPAA

Notice of Privacy Practices FORM—HIPAA

 Request to Correct or Amend PHI form—HIPAA

Revocation of Authorization FORM—HIPAA

If your child is a new patient with a scheduled appointment to see Dr. Colburn or Dr. Weed, please fill out these forms:


Pediatric Patient Information

Pediatric Questionnaire