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Patient Forms

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Preparing for your first office visit is easy.
Please download all of the forms below and fill them out in the comfort of your home to save time in the waiting room.

If you are scheduled for a Dry Eye Appointment please fill out the following form.

Cataract Surgery Information

Below you will find information regarding your Cataract Surgery. Please review all sections prior to surgery. Thank you!

Preparing for Cataract Surgery

Please view/download the information regarding cataract packages and prices below.

The informed consent will need to be completed and brought with you when you meet with your surgeon. Fill out the Informed Consent for Cataract Surgery online here.

For a copy of the entire consent form, including the surgeon portion, click HERE.

You will receive an email with login instructions for the Patient Portal. If you do not receive an email, please contact us. After activating your Patient Portal account on a web browser, you can use the mobile app, APPatient. Download the app below:

Download on the App Store
Get it on Google Play

Pre & Post Operative Cataract Surgery Information

Your family of Eyesight staff is here to assist you with every
aspect of caring for your eyes. Contact information below.


155 Borthwick Avenue
Suite 200 East
Portsmouth, NH 03801
Tel: (603) 436-1773
Fax: (603) 427-0655


McReel Building
192 Water Street
Exeter, NH 03833
Tel: (603) 778-1133
Fax: (603) 778-1055


267 Route 108
Somersworth, NH 03878
Tel: (603) 692-7500
Fax: (603) 692-7575

Kittery, ME

99 US-1, Suite B
Kittery, ME 03904
Tel: (207) 439-4958
Fax: (207) 439-4313

Insurance information

NOTE:  Although we participate with a number of medical insurance plans, there are several vision plans we do not participate with. Please check with your medical or vision plan provider for coverage. If you have questions, please contact our scheduling department at 603-436-1773.

CareCredit Healthcare Credit Card for Better Vision

CareCredit Learn More

There is an easier way to pay for your vision care including cataracts, oculoplastics, glaucoma, and contact lenses or glasses.  Eyesight Ophthalmic Services is pleased to accept the CareCredit credit card, North America’s leading patient healthcare financing program. CareCredit lets you begin your procedure or purchase your eyecare immediately — then pay for it over time with monthly payments that fit easily into your monthly budget. Whether you’re considering cataract surgery, oculoplastic surgery, or it’s simply time for new glasses or contacts, CareCredit can help you see clearer, sooner.

Attention contact lens patients:  Significant savings are available when purchasing 6 month or 1 year worth of contact lenses.  Consider applying for Care Credit and spread your payments out over a 6 or 12 month period – with no interest!  Contact our contact lens specialist to learn more!

Payment Calculator

Your Healthcare Credit Card

CareCredit is the credit card exclusively designed for healthcare services. CareCredit offers special financing on purchase of $200 or more* for healthcare procedures not commonly covered by insurance, including LASIK and Premium-IOLs. Why put off improving your vision tomorrow, when you can see clearer today?


*Subject to credit approval. Minimum monthly payments required. Visit for details.

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