CALL TODAY:305.326.0260
MIAMI EYE CENTER
MIAMI LOCATION
3850 SW. 87TH AVENUE
MIAMI, FLORIDA 33165
THE SELEM CENTER
CORAL GABLES LOCATION
814 PONCE DE LEON BLVD., SUITE 510
CORAL GABLES, FLORIDA 33134
THE SELEM CENTER
HOMESTEAD LOCATION
909 N. KROME AVENUE
HOMESTEAD, FLORIDA 33030

Eye Care Miami, Ophthalmologist Miami, Eye Doctor Miami

Patient Forms

Welcome to Miami Eye Center! Dr. Joseph Selem and our friendly staff are dedicated to providing each patient with the individualized treatment and attention that you deserve. Obtaining personal information and patient history is integral for precise diagnosis and treatment, so these forms should be filled out with care and accuracy. In order to expedite the check-in process during your first consultation, we provide links to our new patient forms below. Simply print out each form, complete them at your leisure from the convenience of home, and bring them with you to your first consultation. On behalf of our entire staff, we look forward to meeting you and showing you a future of clear vision!

Patient Registration

Registro Del Paciente

Patient History

Historial Medico Del Paciente

Consultation Request Form

Notice of Privacy Practices

Receipt of Privacy

Financial Disclosure

Request for Records

Miami Eye Center Appointment Request

Quick Consultation Request

CALL TODAY:
305.326.0260
MIAMI EYE CENTER
MIAMI LOCATION
3850 SW. 87TH AVENUE
MIAMI, FLORIDA 33165
THE SELEM CENTER
CORAL GABLES LOCATION
814 PONCE DE LEON BLVD., SUITE 510
CORAL GABLES, FLORIDA 33134
THE SELEM CENTER
HOMESTEAD LOCATION
909 N. KROME AVENUE
HOMESTEAD, FLORIDA 33030