Home » Patient Info & Forms

Patient Info & Forms

The Indiana Eye Clinic has been providing exceptional eye care for over 30 years. Our experienced doctors, nurses, and staff are committed to providing clearer vision and complete optical health to every patient — whether you need a comprehensive eye exam or treatment for nearsightedness, farsightedness, astigmatism, aging vision, or special health-related vision problems such as cataracts, glaucoma, macular degeneration, diabetic eye disease, or other medical eye conditions. With advancements in refractive and cataract procedures, our surgeons have helped thousands of people live with little or no dependency on corrective eyeglasses or contact lenses.


The Indiana Eye Clinic participates in many insurance plans including Medicare and Medicaid and most commercial plans.  If you have insurance, we will file the claim and after your insurance company has processed the claim, we will send you a statement.  If you have questions about your benefits or how your claim was paid, please contact your insurance company. If you have concerns about a statement from our office, please call our billing department at (317) 881-3937. 

Since most insurance companies consider Refractive Surgery (Laser Vision Correction) an elective procedure, it is usually not covered; however, some plans offer their members a discount. Please check your plan’s coverage.

Financing Options

Often times insurance does not cover all necessary healthcare expenses. This can put a financial strain on those who need medical procedures such as eye surgery. One option is a solution offered by Forum® Credit Union: a “MoneyLine” line of credit.  Visit www.forumcu.com to see their competitive interest rates, payment calculator, and loan application. Click on personal / auto loans.

Other options, such as a Health Savings Account or Flex Savings Account, may be good choices for you. Please contact your local credit union, bank, or finance company, and ask what options may be available.

Note: IEC is not affiliated with Forum Credit Union.


To expedite your office visit, please help us by completing the two interactive patient forms:  1.  Patient Information (2 pgs) and 2. Medical History (1 pg) at least 24 hours before your appointment. Once completed, submit the forms from your computer and we will receive an email notice from our secure database, where we download your information for your medical chart.  If you prefer, you may print out the forms, complete them, and bring them to your appointment. Established patients are asked to update their forms annually.

Note: These documents are in Adobe® PDF format & require Adobe Reader to be viewed. You can download Adobe Reader for free by clicking here.

No Show Policy

Please note that a $25 fee may be assessed for missing a scheduled appointment without contacting us to cancel or reschedule at least 24 hours in advance. Please let us know as soon as possible if you are unable to honor the time reserved for you with your eye doctor.

Refund Policy

Please direct questions regarding refunds, payments or discrepancies to our main office.  Call 317-881-3937 and ask for the Billing Department.

Library Links

There is valuable information about eye health, problems and diseases available on the internet. Here are a few helpful links:

back to top