Patient and Insurance Information

New Patients

Please download the “New Patient Welcome Packet” if you are new to Sirgany Eyecare. If you do not have access to a printer please call the office or send us a message and we will gladly mail the packet to you. The packet includes all of the information you will need before your visit as well as the patient medical history, demographics and insurance information forms. The Notice of Privacy Practices for Sirgany Eyecare are also included, as well as the HIPAA acknowledgement and disclosure authorization forms. Please complete all information in the packet and bring the forms with you to your scheduled appointment. You may also email the completed forms to info@sirganyeyecare.com.

NEW PATIENT WELCOME PACKET & FORMS

RECORDS RELEASE AUTHORIZATION

NOTICE OF PRIVACY PRACTICES

Existing Patients

If you are an existing patient of Sirgany Eyecare and need to update any of your information please download the appropriate forms below and drop them off at the office or send them via direct mail to Sirgany Eyecare at 992 State Rte 13 Cortland, NY 13045 or email them to info@sirganyeyecare.com.

HIPAA & DISCLOSURE AUTHORIZATION FORM

Insurance Plans

The following is a list of insurance plans accepted at Sirgany Eyecare. Please be aware that the list is subject to change. Before scheduling an appointment, please verify that your insurance is accepted by sending a message or giving us a call. As each insurance plan is different, it is the patient’s responsibility to know their eligibility and benefits. Many employers have an explanation of benefits available in the Human Resources Department, or have a phone number for you to call to review your benefits. Sirgany Eyecare has the capability to bill many medical insurance companies for comprehensive eye health exams as well. If you do not have vision insurance but have medical insurance, check with us to see if we are able to bill your exam to your medical plan.