Patient Forms

Thank you for choosing Plainfield Vision Care Center. We are pleased to welcome you as a patient!

In order to help setup your chart and decrease your waiting time to be seen by Dr. Marandola, please print and complete the forms listed below. If you are having difficulties viewing these PDF documents, you may need to download and install the free Adobe Reader software.

Please complete the following forms (click on the links) and bring them with you to your appointment:

  • Patient Insurance Information

  • Receipt of Notice of Privacy Policies & Consent Form

  • Contact Lens Check List

We participate with an array of insurance carriers. If you have any questions regarding your health or vision insurance coverage, please contact your insurance company or our office prior to your visit.

Thank you for entrusting our practice with all of your vision needs. We look forward to taking care of you and your family. Please feel free to contact the office with any questions you may have.