Home - Alabama Oculoplastic Associates
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(205) 930-0700
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1000 19th Street South
Birmingham, AL 35205
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Forms are in PDF format and require Adobe Reader.

Forms

We want your experience at Alabama Oculoplastic Associates to be friendly and efficient. We have included several of our most-used forms to facilitate your visit with us.


New Patient Forms

If you or your child is a new patient and would like to complete most of your paperwork before coming to the office, please complete an adult patient registration (PDF) form and an adult health history (PDF) form. Please complete the pediatric registration (PDF) and pediatric health history (PDF) forms for all patients 16 years and younger.


Medical Records Release

If you need us to send a copy of your medical records to another physician or you need a copy of your medical records, please complete the medical records release (PDF) form and fax it to us at (205) 930-9127. Please allow us 5 to 10 business days to process your request once we have received payment.


Alabama Oculoplastic Associates' Privacy Policy

We respect your privacy. Please review our privacy policy (PDF). Please contact Dusti Hallman at
(205) 930-0700 if you have any questions.