• Having the right type of form at the right time is critical to successful practice administration. For your convenience, AAOE® has created an extensive collection of ophthalmic medical practice forms through the Practice Forms Library. This growing community resource has been developed by AAOE members and consultants willing to share their practice forms. All forms are deidentified and can be modified to suit the needs of your practice.

    Interested in contributing? Please email aaoe@aao.org.

    Practice Forms Library is an AAOE membership benefit. Interested in becoming an AAOE member? Join here.

     Topic Index




    Disclaimer and Limitation of Liability:     These forms are samples shared from practice administrators for inclusion in the Practice Forms Library of the American Academy of Ophthalmic Executives® and can be customized for your practice. They are provided by the Academy for informational purposes only. The Academy does not review, warrant, verify or guarantee the forms. The Academy does not provide legal or accounting services or advice. You should seek legal and/or accounting advice if appropriate to your situation. The Academy, its employees, agents and representatives are not liable to you or any other party to any extent whatsoever for errors in, or omissions from, or inclusions in the forms or for any information they contain. By using the forms, you accept this Disclaimer and Limitation of Liability.

    Practice Forms Library Contributors

    We would like to thank the following AAOE associates who have contributed to this valuable resource.

    Contributor Practice, Location
    Lisa A. Amarant, OCS Practice Administrator
    Carty Eye Associates, Ltd
    Bryn Mawr, Pa.
    Mary Becka Practice Manager 
    Fairview Eye Center
    Cleveland, Ohio
    Daniel M. Bernick, JD, MBA Principal 
    Health Care Group
    Plymouth Meeting, Pa.
    Staci Botter Business Office Manager
    Texas Eye Institute
    Houston, Texas
    Jay C. Collins Practice Administrator
    Rashid, Rice, Flynn & Reilly Eye Associates, PLLC
    San Antonio, Texas
    Temah Copelovitch Administrator
    Chesen Laser Eye Center
    West Reading, Pa.
    Joan Cox Office Manager
    Collegeville Eye Physicians & Surgeons, LLC.
    Trappe, Pa.
    Sandra Dixon Curd, MBA, COE, COA, OCS Chief Operating Officer
    Professional Eye Associates
    Dalton, Ga.
    Cheryl Daugherty Clinic Administrator
    Northwest Eye Clinic
    Bellingham, Wash.
    Gina Deveney Practice Manager
    Burlington County Eye Physicians
    Willingboro, N.J.
    Sandy L. Dilts, MHA, COA Executive Director
    American Health Network Eye Specialists
    Kokomo, Marion and Muncie, Ind.
    Lydia Dimmer, CRA, COT, OCT-C Clinical Manager
    Eye Associates Northwest, PC
    Seattle, Wash.
    Karen DiTola Office Manager
    Briggs Ophthalmology & Associates, SC
    Dyer, Ind.
    Linda Dixon Financial Manager
    Summit Ophthalmology, Inc.
    Akron, Ohio
    Traci Fritz, COE, OCS Practice Administrator
    Children’s Eye Care 
    Detroit, Mich.
    Lisa Gangi, COE Practice Administrator
    Ophthalmic Consultants PA
    Sarasota, Fla.
    Brett D. Gerwin, MD Practicing Ophthalmologist
    Retina Specialty Institute
    Chattanooga, Tenn.
    Pamela A. Hagen Manager
    Tower Clock Eye Center S.C.
    Green Bay, Wis.
    Benjamin M. Higginbotham Chief Operating Officer
    West Coast Retina
    San Francisco, Calif.
    Ann M. Hulett, CMPE CEO 
    EyeHealth Northwest, PC
    Milwaukie, Ore.
    Karyn Iuorno Office Manager
    West End Ophthalmology
    Richmond, Va.
    Anthony P. Johnson, MD, FACS Practicing Ophthalmologist
    Jervey Eye Group P.A.
    Greenville, S.C.
    Kathleen Kemp-Ryan Practice Administrator
    Winchester Eye Specialists
    Winchester, Va.
    Neil Gailmard/Kristin King Viewmont Eye Associates
    Hickory, North Carolina
    Mary Jo Krist, COE Business Administrator
    Eye Consultants of Northern Virginia, P.C.
    Springfield, Va.
    Nancy LaVergne, CPC, OCS Insurance and Billing Director
    Jackson Eye Associates, PLLC.
    Jackson, Miss.
    Susan M. Loen, OCS Practice Administrator
    Bucks-Mont Eye Associates
    Sellersville, Pa.
    Natalie Loyacano, COMT, OSA, OCS, ROUB Practice Administrator
    The VitreoRetinal Eye Center
    Covington, La. / Biloxi, Miss.
    Teri Lueth Coding and Compliance
    North Bay Eye Associates
    Santa Rosa, Calif.
    Joanne Mansour Practice Manager
    The Virginia Retina Center
    Warrenton, Va.
    Paula Meyer Assistant Clinic Manager
    Cataract & Laser Institute of Southern Oregon, P.C.
    Medford, Ore.
    Blanche L. Mindlin Practice Administrator
    Mindlin-Koh Center for Ophthalmic Medicine and Surgery, P.C.
    Bloomfield Hills, Mich.
    Stacey Ostby Clinic Administrator
    Cheyenne Eye Clinic
    Cheyenne, Wyo.
    Liz Parrott, COE, OCS Practice Manager
    Raleigh Ophthalmology
    Raleigh, N.C.
    Diane C. Paskiewicz Practice Administrator
    Consulting Ophthalmologists PC
    Farmington, Conn.
    Michael Payne, MBA Practice Administrator
    Georgia Eye Associates
    Lawrenceville, Ga.
    Joanne Roper Practice Administrator
    Sally Mellgren, M.D., Inc.
    Oceanside, Calif.
    Jeneen Santucci Office Manager
    Gottlieb Eye Center
    Melrose Park, Ill.
    JoAnne Smagacz Practice Administrator
    DuPage Medical Group Eye Specialists
    Downers Grove, Ill.
    Lynn B. Tamborini Office Administrator
    Illinois Retina Institute
    Peru, Ill.
    Terri Ullrich Office Manager
    Davenport Eye Group
    Davenport, Iowa
    Sherri White Executive Director
    Retina Associates of Western New York
    Rochester, N.Y.
    Zella White Administrator
    Eye Center Associates, PA
    Eye Center Optical, Inc.
    Sulphur Springs, Texas