Patient Information and Forms
We care about your personal and medical information. Please review the Notice about how your information is used and disclosed, and how you can get access to this information.
We ask all our new patients to fill out the forms below before their first appointment. Simply click on the links below, print the forms and fill them out before your first visit to Miramar.
Note: You will need Adobe Acrobat Reader to view these forms. If you do not have Adobe Acrobat Reader, you may download it by clicking on the icon below.
Insurance & Financing
Miramar Eye Specialists Medical Group accepts many insurance plans. If you do not see your plan listed, please call 805-648-3085 to see if we accept your plan.
PPO & Vision Plans:
- BLUE CROSS
- BLUE SHIELD
- CHOICE CARE (HUMANA)
- CIGNA/CONNECTICUT GENERAL LIFE/GREAT WEST
- COVENTRY (CCN/FIRST HEALTH)
- FOUNDATIONS FOR MEDICAL CARE
- HEALTH SERVICE GROUP OF CALIFORNIA
- MES (Medical Eye Services)
- MULTIPLAN/PHCS/BEECH STREET
- RAILROAD MEDICARE
- U.S. DEPT. OF LABOR
- UNITED HEALTHCARE/PACIFICARE
- VSP (No Healthy Family VSP Plans Accepted)
Miramar Eye Specialists Medical Group offers financing through CareCredit. Click on the card below to sign up for this service:
CareCredit helps you pay for out-of-pocket healthcare expenses for you and your family. Once you are approved, you can use it again to help manage health, wellness and beauty costs not covered by insurance. Please note this service subject to credit approval.
Discuss with your surgery scheduler to obtain more information.