Patient Resources
Exciting Update: Online Bill Pay Now Available!
Great news! We’ve partnered with InstaMed to simplify your medical billing experience. Create an InstaMed Account and simplify the way you manage and pay your healthcare bills for all of your providers and family members. Get started at the link below:
For Your Visit!
The team at Pacific Eye Institute is dedicated to making your experience with us an exceptional one. For your convenience, we’ve made our patient forms available online to help make your visit easy and convenient. Prior to your visit, please print, complete and sign the appropriate forms, and give them to our staff upon your arrival.
In addition to the forms below please be sure to bring:
- Insurance card or proof of insurance
- Picture I.D. with current address
- Name of your current pharmacy, address and phone number
- Co-payment or Deductible (payment is due at time of service)
Prior to your visit at Pacific Eye Institute, we ask that you complete the online patient registration via the link below. Patients may also complete additional paperwork prior to their visit by visiting the patient forms section on this page.
All Patients
Surgical Patients
Transform your vision without financial stress! Our practice proudly accepts the Alphaeon Credit Card, tailored for health and wellness needs, including cataract surgery, premium IOLs, glasses, contacts, and more. With Alphaeon Credit, you can start your eye care journey today and pay overtime with flexible monthly plans that suit your budget. Don’t let cost delay clearer vision!
Why Choose the Alphaeon Credit Card?
- Flexible monthly payment options to meet your vision care goals.
- Special financing on purchases of $250 or more*—unlike standard credit cards.
- Reuse your card for future treatments for you or your family, no reapplication needed.
- Covers services often not included in insurance, such as LASIK and premium IOLs.
- Check pre-qualification online** with no impact on your credit score.
Disclaimers:
*$ Subject to credit approval. Purchases must be made using the ALPHAEON CREDIT Card Account, issued by Comenity Capital Bank, which determines credit qualifications and promotion eligibility. Minimum payment is $27.00. Minimum interest charge is $3.00 per plan. Standard variable APR is 32.99% (based on the Prime Rate). Valid for single transactions only.
** A soft inquiry is used to check your eligibility, which will not affect your credit score.
There is an easier way to pay for your vision care, including LASIK. We’re pleased to accept the CareCredit credit card, North America’s leading patient healthcare financing program.
CareCredit lets you begin your procedure immediately — then pay for it over time with monthly payments that fit easily into your monthly budget.
Whether you’re considering LASIK, need cataract surgery, or it’s simply time for new glasses or contacts, CareCredit can help you see clearer, sooner.
Payment Calculator
Your healthcare credit card
CareCredit is the credit card exclusively designed for healthcare services. CareCredit offers special financing on purchase of $200 or more* for healthcare procedures not commonly covered by insurance, including LASIK and Premium-IOLs. Why put off improving your vision tomorrow, when you can see clearer today?
*Subject to credit approval. Minimum monthly payments required. Visit www.carecredit.com for details.
We are continually working to add new accepted insurance plans to our network. We have added several new providers in 2025. Please view our insurance list below and if you have questions please feel free to contact us!
To request your medical records, please click on the button and follow the steps:
Understanding which insurance applies to your eye care visit can feel confusing. That’s why we created this short video to explain the difference between health insurance and vision insurance, and when each one is used.
Both health and vision insurance play an important role in keeping your eyes healthy and your vision clear:
- Health insurance generally covers medical eye exams and treatments related to eye health — such as glaucoma, cataracts, or eye injuries.
- Vision insurance helps with how you see day-to-day. It often covers routine eye exams, prescription glasses, contact lenses, and other vision services.
- Some plans (like Medicare) may cover certain medical services but not routine refraction tests for glasses prescriptions.
- Even if adult vision benefits aren’t included, most health plans provide children’s vision services.
To make the most of your benefits, please:
- Bring both your health insurance card and, if you have one, your vision insurance card to your appointment.
- Provide a printed list of all current medications.
- Ask our friendly staff any questions — we’re here to help.
