{"id":681,"date":"2019-05-05T08:47:11","date_gmt":"2019-05-05T14:47:11","guid":{"rendered":"https:\/\/topekaeyecare.com\/eyecare\/?page_id=681"},"modified":"2025-04-03T07:44:08","modified_gmt":"2025-04-03T13:44:08","slug":"forms","status":"publish","type":"page","link":"https:\/\/topekaeyecare.com\/eyecare\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"post\" data-elementor-id=\"681\" class=\"elementor elementor-681\" data-elementor-settings=\"[]\">\n\t\t\t<div class=\"elementor-inner\">\n\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-element elementor-element-32ec44b elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle elementor-section elementor-top-section\" data-id=\"32ec44b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_image&quot;:{&quot;url&quot;:&quot;https:\\\/\\\/topekaeyecare.com\\\/eyecare\\\/wp-content\\\/uploads\\\/2019\\\/02\\\/DSC02274.jpg&quot;,&quot;id&quot;:474},&quot;background_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;},&quot;background_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;}}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-58e37b3 elementor-column elementor-col-100 elementor-top-column\" data-id=\"58e37b3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4b00fba animated-slow elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"4b00fba\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;,&quot;_animation_delay&quot;:200}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Forms &amp; Document Download<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-element elementor-element-0a119a4 elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-section elementor-top-section\" data-id=\"0a119a4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5d0ac6a elementor-column elementor-col-100 elementor-top-column\" data-id=\"5d0ac6a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-628ebdb elementor-widget elementor-widget-text-editor\" data-id=\"628ebdb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\"><h3 style=\"text-align: center;\">Click the following links to download our forms and documents.\u00a0<\/h3><hr \/><ol><li><h5><a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2025\/04\/20250402125436870.pdf\">Contact Lens Policy update 2025<\/a><\/h5><\/li><li><h5>\u00a0<a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2020\/01\/AUTHORIZATION-TO-RELEASE-INFORMATION.pdf\">Authorization to Release Information<\/a><\/h5><\/li><li><h5><a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2019\/04\/General-297-HIPAA.pdf\">HIPAA \u2013 Health Insurance Portability and Accountability Act<\/a><\/h5><\/li><li><h5><a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2019\/07\/Revised-DRO-Direct.pdf\">DRO Direct Savings Plan<\/a><\/h5><\/li><li><h5><a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2019\/08\/Fall-Newsletter.pdf\">Newsletter<\/a><\/h5><\/li><li><h5><a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2021\/01\/20210115130111163.pdf\">Registration\/Hippa Approved Contacts<\/a><\/h5><\/li><\/ol><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-element elementor-element-181662b elementor-section-height-min-height elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-items-middle elementor-section elementor-top-section\" data-id=\"181662b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;},&quot;background_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;},&quot;background_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;}}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4bf4dd8 elementor-column elementor-col-50 elementor-top-column\" data-id=\"4bf4dd8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8fa0e34 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"8fa0e34\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why us?<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eab54ef elementor-invisible elementor-widget elementor-widget-divider\" data-id=\"eab54ef\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInLeft&quot;,&quot;_animation_delay&quot;:200}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\"><\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2810482 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"2810482\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInLeft&quot;,&quot;_animation_delay&quot;:400}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\">Hello. Great to see you.<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-42c56eb elementor-column elementor-col-50 elementor-top-column\" data-id=\"42c56eb\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<section class=\"elementor-element elementor-element-2472743 elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-invisible elementor-section elementor-inner-section\" data-id=\"2472743\" data-element_type=\"section\" data-settings=\"{&quot;animation&quot;:&quot;slideInRight&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-194a08f elementor-column elementor-col-100 elementor-inner-column\" data-id=\"194a08f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9cea893 elementor-widget elementor-widget-text-editor\" data-id=\"9cea893\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\"><p>We\u2019re so glad you made it here and we\u2019re looking forward to meeting you face-to-face soon. You obviously care about your vision as part of your overall health and have chosen a provider that cares about you. Here are a few things your should know before you first appointment.<\/p><p style=\"text-align: center;\"><strong><span style=\"color: #ffffff;\"><a style=\"color: #ffffff;\" href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2019\/04\/General-32-Records-Release.doc.docx\">Record Release Form<\/a><\/span><\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cddb2ff elementor-align-left elementor-tablet-align-center elementor-hidden-desktop elementor-invisible elementor-widget elementor-widget-button\" data-id=\"cddb2ff\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;,&quot;_animation_delay&quot;:600}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a href=\"https:\/\/topekaeyecare.com\/eyecare\/wp-content\/uploads\/2019\/04\/General-32-Records-Release.doc.docx\" class=\"elementor-button-link elementor-button elementor-size-sm elementor-animation-float\" target=\"_blank\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Record Release Form<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-element elementor-element-58b5f1a elementor-section-height-min-height elementor-section-boxed elementor-section-height-default elementor-section-items-middle elementor-section elementor-top-section\" data-id=\"58b5f1a\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;},&quot;background_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;},&quot;background_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;}}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t<div class=\"elementor-row\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a484a3c elementor-column elementor-col-100 elementor-top-column\" data-id=\"a484a3c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-column-wrap  elementor-element-populated\">\n\t\t\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t<div class=\"elementor-element elementor-element-555425f elementor-widget elementor-widget-heading\" data-id=\"555425f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Insurance <\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c809911 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"c809911\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInLeft&quot;,&quot;_animation_delay&quot;:400}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\"><p><span style=\"font-weight: 400;\">Let\u2019s talk coverage.<\/span><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-604e837 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"604e837\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;slideInLeft&quot;,&quot;_animation_delay&quot;:400}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-text-editor elementor-clearfix\"><p>Did you know that in many cases, your regular health insurance will cover your eye exams? You may not need separate vision care insurance. We recommend checking with your insurance company first to see if we are a covered provider. Don\u2019t let the confusion of insurance prevent you from making your appointment. We can help you throughout the process and are more than happy to find out what the best coverage option is for you.<\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Forms &amp; Document Download Click the following links to download our forms and documents.\u00a0 Contact Lens Policy update 2025 \u00a0Authorization to Release Information HIPAA \u2013 Health Insurance Portability and Accountability Act DRO Direct Savings Plan Newsletter Registration\/Hippa Approved Contacts Why us? Hello. Great to see you. We\u2019re so glad you made it here and we\u2019re &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/topekaeyecare.com\/eyecare\/forms\/\"> <span class=\"screen-reader-text\">Forms<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/pages\/681"}],"collection":[{"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/comments?post=681"}],"version-history":[{"count":20,"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/pages\/681\/revisions"}],"predecessor-version":[{"id":1031,"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/pages\/681\/revisions\/1031"}],"wp:attachment":[{"href":"https:\/\/topekaeyecare.com\/eyecare\/wp-json\/wp\/v2\/media?parent=681"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}