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Tennessee River Eye Clinic Mark A. Tassels, M. D and Jan C. Lens, O.D. 1110 S. Montgomery Ave Sheffield, AL 35660 2563812020 2563817754Release of Medical Records Authorization Patients Name(Print)
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To fill out Tennessee River Eye Clinic, follow these steps:
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Begin by providing your personal information such as your name, address, and contact details.
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Next, provide your medical history, including any previous eye conditions or surgeries.
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Fill in your insurance information, including your policy number and primary insurance provider.
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Specify the reason for your visit and any specific concerns or symptoms you are experiencing.
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If you have a referral from another healthcare provider, make sure to include that information.
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Lastly, review the completed form for accuracy and sign it before submitting it to the clinic.

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Anyone who is in need of eye care services can benefit from Tennessee River Eye Clinic. This includes individuals experiencing vision problems, eye diseases, or requiring routine eye exams. The clinic is equipped to handle patients of all ages, from children to the elderly. Whether you need an eyeglass prescription, contact lens fitting, treatment for an eye condition, or consultation for eye surgery, Tennessee River Eye Clinic can provide comprehensive care.
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Tennessee River Eye Clinic is a clinic specializing in eye care located in Tennessee.
Patients who receive services from Tennessee River Eye Clinic are required to provide necessary information for filing purposes.
To fill out Tennessee River Eye Clinic forms, patients need to provide personal information, insurance details, and medical history accurately.
The purpose of Tennessee River Eye Clinic is to provide quality eye care services to patients in need.
Information such as patient's name, contact details, insurance information, medical history, and treatment provided must be reported on Tennessee River Eye Clinic forms.
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