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Simulated Clinic Website: anderseneye.com
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https://www.anderseneye.com/patient-forms-and-intake
UNPROTECTED: 3 Untagged PDFs Exposed
Andersen Eye Associates
Ophthalmology & Laser Vision Center (20+ Staff) • Saginaw, MI • Accepting Medicare & Medicaid
Download Required Patient Registration & Medicare Forms
Please download and complete these PDF forms prior to your appointment at Andersen Eye Associates:
New Patient Registration & Medicare Intake
File:
New_Patient_Registration_2026.pdfHIPAA Privacy Notice & Consent Form
File:
HIPAA_Privacy_Notice_Consent.pdfMedicare / Medicaid Assignment of Benefits
File:
Medicare_Financial_Assignment.pdf