www.WorldEyeGlasses.com 6201 N. Federal Hwy, Fort Lauderdale, Florida 33308 (ON FEDERAL HWY. Between Commercial & Atlantic Blvd.- In SAME Plaza as OUTBACK & SUBWAY)  


About Dr. Gary Enker
Owner & Board Certified Optometrist

Visit AllAboutVision.com for guides to glasses and contacts, and to learn about eye health topics such as cataracts and glaucoma

 

 

Not sure what to do?  Please follow the instructions on this page.

You may Also Print & Fax ( Fax #: 954-491-7164 )

Exam Registration

 

Patient Information

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Whom may we thank for referring you to us?
 
 

PATIENT EMPLOYMENT INFORMATION

 
 
 
 
 
 
 
 
If the RESPONSIBLE PERSON and PATIENT Info is the same,
 

 

FINANCIAL RESPONSIBILITY INFORMATION

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

RESPONSIBLE PERSON EMPLOYMENT INFORMATION

 
 
 
 
 
 
 
 

Pre-Approval

 
Do we accept your insurance? Most Likely ...but we still have to process it. Depending on your insurance provider, this process can be time consuming while we try to get the approval necessary for us to proceed with your eye care plan. Sometimes we find out that your insurance company may have a problem with your coverage that we can correct for you, before you even enter our office! We truly want to make your visit to our office a pleasant visit, so our experienced staff will go to work on getting the best coverage possible that you are entitled to by your insurance carrier.
 
If the Patient has Vision Insurance, and you have not supplied us with this information
 

 

OTHER INFORMATION

 
You may elaborate on any information below, and/or in the office
 
 

 
 
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