THE BRADLEY EYE CARE CENTER
  • Home
  • ABOUT US
  • Vision Care & Products
  • Patient Forms
  • Location

patient forms

Patient Forms

Patient Info Form
File Size: 1457 kb
File Type: pdf
Download File

HIPAA Consent Form
File Size: 124 kb
File Type: pdf
Download File

VSP Consent Form
File Size: 73 kb
File Type: pdf
Download File

Contact Lens Agreement
File Size: 105 kb
File Type: pdf
Download File

Record Release Form
File Size: 103 kb
File Type: pdf
Download File

Wellness Form
To comply with current CDC Guidelines for practicing during the COVID-19 Pandemic, we are asking all patients to complete a Wellness Form either by clicking the link above or taking one from our office door before being seen in our office. This is for the safety of our staff and other patients.

To save time, please download, print and complete the Patient Information Form and the HIPPA Consent Form prior to your appointment. If you have VSP, please download the VSP Consent Form in addition to the above forms.

Thank you. ​We look forward to serving you!
Contact Us! 
76 Mouse Creek Road
Cleveland, TN 37312
Phone: 423-472-5085
​(call or text)
Office Hours
Mon    8:30 am - 4:00 pm 
Tue      8:30 am - 5:00 pm
Wed   8:30 am - 4:00 pm
Thu     8:30 am - 5:00 pm
Fri       8:30 am - 1:00 pm




​Notice of Privacy Practices

Website by Eyefinity
  • Home
  • ABOUT US
  • Vision Care & Products
  • Patient Forms
  • Location