Forms & Insurance

Online Forms

Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.

Medical History - Submit Online | Download & Print

Patient Intake - Submit Online | Download & Print

Financial Policy - Submit Online | Download & Print

Acknowledgement of HIPAA Privacy
Submit Online | Download & Print

Cancellation / No Show Policy
Submit Online | Download & Print

Optomap - Submit Online | Download & Print

Participating Insurances

  • Eyemed
  • VSP
  • Davis
  • NVA
  • Avesis
  • Heritage
  • Zenith Admin
  • Medical Eye Service
  • Tricare
  • Spectera
  • Superior Vision
  • Cigna Vision

We accept Cash, Check, Visa, MasterCard, American Express, Discover, Flexible Spending Plans, and Health Savings Accounts (HSA).

Satisfaction Survey

At Bettner Vision, we believe in continual improvement of our services. Please take a few moments and share your experience with our office. We appreciate your feedback!

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