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877-249-2020 • info@streckereye.com

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New Patient Forms

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  2. New Patient Forms
New Patient Formsfred@thatwebdesign.com2023-06-08T21:56:17-04:00

Download and print out our new patient forms

New Patient Registration Form

New Patient Hippa Form 1

New Patient Hippa Form 2

Medical History Questionnaire

Waiver for all incoming patients with credit card option

  • Home
  • Meet Dr. Strecker
  • Cataract
  • LASIK
  • Botox
  • Dermal Fillers
  • Eyelid Surgery – Blepharoplasty
  • Glaucoma Laser
  • Contact Us
  • New Patient Forms
  • Reviews

HINGHAM

Phone: 781.383.2555
Fax: 781.383.6660
169 Lincoln Street
Suite 201
Hingham, MA 02043

PLYMOUTH

Eye and Aesthetic Laser Center
508-747-3338
225 Water St.
Plymouth, MA 02360

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