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Bluegrass Eyecare Center

Bluegrass Eyecare Center

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    • Irfan Ansari, MD
    • Anthony Bisotti, OD
    • C. Richard Bowers, Jr., MD
    • Marsha K. Penn, MD
    • Daniel Good, MD
    • Jeremy Smith, OD
    • Khalil Harbie, MD
    • Kenneth Weaver, MD
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Home » Patient Forms

Patient Forms

By printing out and completing your New Patient Forms before your first visit, you can expedite your visit with Bluegrass Eye Center.

These forms must be completed before you see a provider.

Please call our office to set an appointment at (859) 278-8443.

Patient Information

Lexington New Patient Form Online

Georgetown New Patient Form Online

If you prefer, you can print out and complete the Patient History Questionnaire.

Viewing these forms requires the FREE Adobe Acrobat Reader.

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