STEEL CITY EYE CARE
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Patient Forms

Patient Forms

Please fill out the following patient information form and bring it with you along with any current glasses or contacts you might wear. 

  • ​Welcome Patient History and Consents form​ (please print and fill)

  • Welcome Office HIPPA  Insurance and Dilation Procedure Information​ (for reference only)











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Steel City Eye Care

2937 7th Ave South, Suite 104
Birmingham, AL  35233

Voice:  205-203-4837
Text:    205-447-6774
Fax:     205-327-1349

Email:
  info@steelcityeyecare.com
Office Hours:

Mon:  8am - 2pm
​
Mon:  8am - 2pm
​Tues:  8am - 2pm

Monday-Friday:  8-2pm
By Appointment



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Copyright © 2019  Website by Eyefinity
  • Home
  • About Us
  • Request Appointment
  • Services
  • Patient Forms
  • Map
  • Rebates
  • Privacy Practices