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Changmin Duan, O.D., P.A.
Patient Forms
First Time Patients?
If yes, please fill out these 3 pages of information and bring them with you to the doctor's office. Also remember to bring your insurance card/s and referrals if applicable. This will save you waiting time.
是第一次到我们诊所看病吗？ 如果是，请下载并填写好三张表格，一并带到我们诊所，这样会节省你等待的时间。第三张表格是HIPAA(Health Insurance Portability and Accountability Act), 是关于你授权我们可以用你的信息申报你的保险。请不要忘记带上你的医疗保险卡。如果你的保险需要转诊单，请让你的家庭医生提前开好。
If you need your medical records for personal use, please fill out this form to authorize its release. Please include the patient's and recipient's information.
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