Patient Forms

Your First Visit

Woman Smiling while using a LaptopThank you for choosing Eye Associates of New Mexico for your eye services. We are committed to servicing our patients with integrity and providing the highest quality healthcare. Please bring your insurance identification cards and any medications you are taking. If you have been under the care of another doctor, we may ask your permission to obtain a copy or transfer some of your records.

Please plan on arriving 15 min early for your first visit. You will be required to fill out patient registration, patient history, and review of systems forms. This information will help your doctor to evaluate your current health as it relates to your eye care. We update this information annually to ensure we have accurate records. To expedite the registration process, please print and complete the forms below.

Patient Forms

Please click on the links below to download the appropriate patient forms in Adobe PDF format:

Annual Patient History and Review Patient Registration Pediatric History Pediatric Consent for Diagnosis & Treatment of a Minor Medical Records Release Form Notice of Nondiscrimination Eye Associates Notice of Privacy AAESC Notice of Privacy Form

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PATIENT INFORMATION

Our Patient Information Center makes it easy for you to do the following:

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OUR LOCATIONS

Albuquerque - Northside

5757 Harper Dr NE,
Albuquerque, NM 87109

Albuquerque - Promenade

5200 Eubank NE, Suite A-4 Promenade Center
Albuquerque, NM 87111

Albuquerque - Regina Hall

806 Dr. Martin Luther King, Jr. Ave.
Albuquerque, NM 87102-3657

Albuquerque - Retina Center

4411 The 25 Way NE, Suite 325
Albuquerque, NM 87109,

Espanola

412 Paseo de Onate St., Suite #2
Espanola, NM 87532

Farmington

622 West Maple, Suite E
Farmington, NM 87401

Gallup

311 East Nizhoni Blvd
Gallup, NM 87301-5791

Las Vegas

248 Mills Ave.
Las Vegas, NM 87701

Los Alamos

1623 Central Avenue
Los Alamos, NM 87544

Los Lunas

1603 Main Street SW, Suite B
Los Lunas, NM 87031

Rio Rancho

1740 Grande Blvd, Suite B
Rio Rancho, NM 87124

Roswell

1606 S.E. Main St.
Roswell, NM 88203

Santa Fe

2947 Rodeo Park East
Santa Fe, NM 87505

Taos

1399 Weimer Rd., Suite 300
Taos, NM 87571