You can be assured that you will receive the best possible care at Chelsea Eye & Cosmetic Surgery Associates.  Ours is a full service ophthalmology and cosmetic surgery practice, committed to delivering the most advanced medical and surgical treatment in a warm, compassionate environment. 

We specialize in the most advanced all laser (Intralase) and custom LASIK surgery for the correction of nearsightedness, farsightedness and astigmatism to reduce or eliminate the need for eyeglasses and contact lenses.  In our cosmetic surgery center our specialists provide aesthetic services such as cosmetic and reconstructive surgery of the eyelids and face, Botox, Restylane, Radiesse, Sculptra, ArteFill, Juvederm, laser skin resurfacing, and cosmetic skin care treatments such as Thermage, chemical peels, laser hair removal and Intense Pulsed Light therapy (IPL).

For your convenience, the forms required for your initial visit to our practice are listed below. Click on each form, print it out and fill in the required information. You may either fax the completed forms to 212-727-3789 or bring them with you to your appointment.

Comprehensive eye examinations, LASIK evaluations and plastic surgery consultations normally require one to one-and–a-half hours for new patients. Dilation of your pupils may be required for the examination. As the effect of dilation can take a few hours to wear off, it is best that you do not plan to drive or read immediately after the appointment, and because your eyes may be sensitive to light following dilation, it is advisable to have sun glasses with you. Ocular evaluations may also include visual field testing, optic nerve analysis and possibly other specialized corneal or glaucoma testing. These tests may require more time to complete.

Please bring your insurance or health coverage card(s), a list of any eye drops or other medications that you are currently using and your eyeglass and/or contact lens information (bottles or boxes in which the contact lenses are packaged) when you come for your appointment.

Medical evaluations and treatments are usually covered by medical insurance. We cannot accept medical insurance as payment for cosmetic consultations or treatments, and payment for these services will be collected at the time of your visit. Cosmetic treatments and LASIK may be covered under flexible spending accounts.

A Cosmetic Consultation is an evaluation for treatments or elective procedures/surgeries that are not medically necessary but are for the sole purpose of improving one’s appearance (i.e. wrinkles, “baggy” lids, loss of volume to the face, lip enhancement, etc). Clinical photos will be taken; patients considering cosmetic eyelid surgery will have a basic eye exam as a part of the cosmetic consultation. Cosmetic consultations and treatments are not covered as “medically necessary” by insurance carriers, although they may sometimes be paid for with flexible spending accounts. The cost of this exam is $200 and will be applied to the cost of the treatment or surgery if within 6 months of the exam.

A Plastic Consultation is an evaluation of a medical condition of the eye and surrounding structures (i.e. eyelids, bony structure, drooping eyelids (ptosis), a lid that turns in and eye lid lesion) that interferes with normal functioning. Digital ocular photos must be taken as a part of the medical exam. If you have a medical condition, the fees, including ocular photos and medical tests, may be submitted to your insurance carrier for reimbursement and you will be responsible for co-payments, etc. You will be asked to sign a photo waiver acknowledging your responsibility for the cost of medical photos if your insurance carrier denies payment.

Any required co-payments and deductibles will be collected from you as indicated by your health plan. Payment is requested at the time of the visit for any co-payments, deductibles, or services not covered by your health care plan. Payment may be made by cash, check, MasterCard, Visa or American Express.

Many health care plans require the patient to obtain a referral from their primary care doctor for every visit to the specialist, including follow up visits, and we cannot bill your insurance company for our services if you do not provide us with this referral. Your doctor may mail or fax the referral directly to us, or you can bring it with you.

We know your time is valuable, and we make every effort to see patients in a timely manner.  If you have not been seen within 15 minutes of your arrival time, please let the receptionist know.

We look forward to meeting you, and we thank you for choosing Chelsea Eye & Cosmetic Surgery Associates.  If you have any questions, please feel free to call us at 212.727.3717, or visit our web site at www.ChelseaEye.com.

 

The above forms are e-published in Adobe Acrobat Reader.pdf format. If you do not have it installed on your system, please do so by going to http://www.adobe.com/products/acrobat/readstep2.html