Patient Portal
278 Benedict Ave. Ste 300. Norwalk, OH 44857 | 419-668-3295

Patient Center

Online Forms

Welcome to our patient center! Speed up your visit by completing the necessary form(s) below. For your convenience, you can either fill the form(s) out online or download and print the form(s) and bring it with you to your appointment.

Registration Form - Download & Print

Records Release - Download & Print

HIPAA - Download & Print

Payment Options

At North Central Eye Associates, Inc., our mission is to provide quality service and products at reasonable pricing. We accept the following payment methods:

  • Cash
  • Check
  • Visa, MasterCard, and Discover
  • Flexible Spending Plans
  • Health Savings Accounts (HSA)

Participating Insurances

Our practice accepts most insurance plans, Medicare and Medicaid. Coverage may vary from one plan to the next.  We do not accept vision insurance for our ophthalmic services or optical shop.  However, if your office visit reveals a medical diagnosis, this will be applied to any current medical insurance and your visit will be covered accordingly.  Please call our office to verify your benefits before your visit.

Satisfaction Survey

At North Central Eye Associates, Inc., we believe in continual improvement of our services. Please take a few moments and share your experience with our office. We appreciate your feedback!

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COVID-19 Update: (April 29, 2020)

At North Central Eye, we have been working diligently to maintain a safe environment for our physicians, our staff and most importantly, our patients. We have changed numerous operations to limit exposure, and you may notice some changes in the office and in our optical shop, both of which are open and ready to serve you. In addition to our efforts of meticulously cleaning each room and rotating the rooms used each day, please expect the following for your safety:

  • All patients should wear a mask while in the building.
  • Patients should check in by calling 419-668-3295 from the parking lot. Our staff will then call you to tell you when to enter the building, in order to control our ability to provide adequate social distancing. Our waiting room now has a limited number of seats spaced far apart.
  • Only the patient should come into the office. Spouses, friends, or other companions should wait in the car in order to lessen exposure.
  • In our optical shop, please do not touch the frames on display. Our optical technicians will assist you, and you can point to the frames that you would like to try on. After each session is finished, every pair of frames touched is cleaned.
  • If you have an outstanding bill, please feel free to call and we can process it over the phone with your credit card rather than in person.

Most importantly, if you have;

  • experienced any coronavirus-like symptoms; fever, cough, shortness of breath, difficulty breathing, shaking chills, loss of taste or smell, sore throat, fever, or
  • have tested positive for COVID-19, or
  • been exposed to an individual with known COVID-19, please call 419-668-3295. We would like to reschedule you to a time when you feel better and/or have been cleared by your doctor.

Finally, thank you for your patience through this challenging ordeal. Your support of us- as a small business and a group of front-line medical workers- is what makes us proud to serve our local community.