Moulton Eye Clinic - Providing Complete Eyecare to Lawrence County and Northwest AL
How to Contact Us:
 
 
 
 
Office phone number:  (256) 974-4555
 
If you call us during non-business hours, please leave a voicemail with your name and phone number and we will contact you at the beginning of the next business day.  An emergency number is available on our voicemail message for eye emergencies.
 
If you would like to schedule an appointment, ask a question, or just tell us how we're doing, please fill out the form below and we will contact you as soon as possible!
 
 
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Office Forms for New Patients:
 
 
If you are a new patient, have an exam scheduled, and would like to complete your paperwork BEFORE the day of the exam, we highly encourage you to print these sheets below, complete them at home, and bring them to your eye exam.  Thank you and we look forward to seeing you soon!
 
 
WELCOME FORM
 
 
HEALTH HISTORY 2
 
HIPAA FORM
 
COPY OF HIPAA GUIDELINES
 
ABN FORM (MEDICARE ONLY)
 
 
 
 
 
 
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