Online Forms

At Kimberly Ann Lucey M.D., P.C., we value your time. In an effort to save you time in our office, you can download and complete our patient forms prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Download the Free AdobeReader®
  • Download the required forms. Print out the forms and complete the required information.
  • Bring your printed and completed forms to our office.

Patient Registration

Please complete this form as it lets us know the history and current state of your health.

Notice of Privacy Practices

If you have any questions, please do not hesitate to contact our office by calling (860) 749-6485

Cataract Surgery Questionnaire

In order to better assess your visual needs and guide you toward the best choice of intraocular lens to meet your expectations, please print out and complete this survey ahead of your scheduled appointment.