New Patient Paperwork



Thank you for choosing Retina Associates of Kentucky for your. Our physicians and staff are committed to providing care that meets or exceeds your expectations. Our goal is to bring hope and vision to you in a compassionate, personalized and timely manner.


Your First Visit

At the time of your appointment, please be sure to bring:

  • Insurance card
  • Photo ID
  • List of current medications
  • List of surgical procedures
  • Dark sunglasses
  • Someone to drive you

Completed new-patient paperwork:

These forms are pdf files. You will need Adobe Reader to open them.
If you do not have Adobe Reader please click the button below
to go to to download it.

Click here to download Adobe Reader


How long will I be there?

Each patient is unique, but you can plan on spending between 2-4 hours in our office.


What will happen?

In addition to a comprehensive eye examination performed by one of our nationally recognized physicians, we are proud to offer state-of-the-art diagnostic testing facilities and the most advanced, innovative treatments for your condition.


If you have questions about your insurance coverage before your visit, you may contact our Billing Department at 1-800-627-2020 and select the prompt for Billing. You may also contact our Billing Department through email at


Workers’ Compensation patients must bring:

  • The name of the employer at the time of injury
  • The name of your Workers’ Comp insurance carrier
  • Your Workers’ Comp claim number
  • The date and time of your injury
  • A letter from your employer or Workers’ Comp insurance carrier verifying coverage for the injury or condition