Valley Eye &amp; Laser Center<br />&#8203;Jonathan D. Jahnke, M.D.
  • Valley Eye Center
  • LASIK
  • BOTOX
  • Cataract Surgery
  • Frequently Asked Questions
  • Valley Optical
  • New Patients
  • Meet the Staff

Patient Forms

Printable forms for your convenience

​We're excited you're coming in! 



To help speed up your check-in process at our office please download and fill out the following forms prior to your visit.
Remember to bring them with you signed and dated. 

Please remember your current insurance card, photo ID, and an updated medication list. 
New Patient Packet
HIPPA
Contact Lens Agreement
Record Release
​
Alternate Contact Consent

Insurance Plans Currently Accepted at Valley Eye Center
This is not a guarantee of payment or coverage. If you have any questions or concerns, contact your insurance company.

  • Aetna
  • Cigna
  • Health Net (medical only)
  • Humana
  • LifeWise
  • Medicare (medical only)
  • Moda Health
  • PacificSource
  • Providence Health Insurance
  • Providence Medicare (may require referral for medical exam, please check with your insurance carrier)
  • Regence Blue Cross Blue Shield
  • Tricare (medical only)
  • United Healthcare (Out of network, medical only)
  • VSP (vision only; we are not providers for all plans, please check with carrier prior to making an appointment)
  • Worker's Comp​
We are no longer able to accept new patients with Oregon Health Plan or Medicaid,
We are NOT providers for First Choice Health or EyeMed.

FAQ
Home

Facebook