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South Carolina Laser Eye Surgery
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Save Time in Our Office Completing Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms, ahead of time, you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

If you already have a copy of Adobe Acrobat Reader, then you may download a form immediately by clicking on the name of the form below. The PDF file sizes are relatively small and will take only a few minutes to download, depending upon your modem and connection speed. When the file transfer is complete, just click on the filename to launch Acrobat Reader and open the form and print it.
For your initial visit, please print and fill out the following three forms:

Patient History Form Patient Registration Form
Financial Agreement Refractions
Privacy Information Form  

Get Adobe Reader, if you do not have Adobe Reader you can get it for FREE.


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Janet Minick
Human Resources

Dr. Ply is the best! I would recommend him and his staff to anyone wanting great vision. It has been three weeks from my surgery and I can see 20/15. I see clearly when I wake up in the morning, all during the day, and when I drive at night. My eyes stay clear looking and are never irritated. Thank you Dr. Ply and your excellent, caring staff of professionals!

 

In many cases your insurance may cover eye care expenses. Our staff will be happy to review your coverage with you. We participate in a variety of insurance plans including Medicare, Blue Cross/Blue Shield, Grand Strand Affordable, AEtna, Premier,.............

 

We Have Two Locations

3911 Highway 17 Bypass Murrells Inlet, SC 29576 (843) 651-8200

8028 Myrtle Trace Drive Conway, SC 29526
(843) 347-7236

 

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