Online Forms

At Dr. Tufte & Associates Eyes on 45th, we value your time. In an effort to save you time in our office, you can download and complete our patient forms prior to your appointment.

  • You will need AdobeReaderĀ® to download and complete the forms.  
  • Download the required forms. Print out the forms and complete the required information.
  • Fax (701.282.3763) or email ([email protected]) your completed forms to our office or bring them with you to your appointment. 



HIPAA Agreeement

Patient Financial Information Form

Patient History Information Form

Optomap Authorization Form


Download the Free AdobeReaderĀ®

Locations

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Hours of Operation

Our Regular Schedule

Monday

8:00 am - 5:00 pm

Tuesday

8:00 am - 5:00 pm

Wednesday

8:00 am - 5:00 pm

Thursday

8:00 am - 5:00 pm

Friday

8:00 am - 3:00 pm

Saturday

Closed

Sunday

Closed

Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
8:00 am - 3:00 pm
Saturday
Closed
Sunday
Closed