Patient Center

At Charlevoix Eye Center we believe in continual improvement of our services. Please take a few moments and share your experience with our office. We appreciate your feedback!

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Online Forms

Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.

New Patient Form (Required) - Download & Print

Patient Health History Form (Required) - Download & Print

Notice of Privacy Practices (Optional) - Download & Print

Privacy Practices Form (Required) - Download & Print

Individualized Lenses Form (Optional) - Download & Print

Payment Options

At Charlevoix Eye Center, our mission is to provide quality service and products at reasonable pricing. We accept the following payment methods:

Our Office Accepts

• Cash

• Check

• Visa, MasterCard, American Express and Discover

• Flexible Spending Plans

• Health Savings Accounts (HSA)

• CareCredit


Participating Insurances

Our practice accepts most insurance plans. Coverage may vary from one plan to the next. Please call our office to verify your benefits before your visit.