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Patient Forms

For your convenience, the necessary patient forms have been included below to be completed before your next appointment.  You may download, print and complete the forms before arriving at the office.

     The forms below include: 

  • "New Patient Form" for new patients (please complete all four pages)

  • "Established Patient Form" for established patients with updated information

All patient forms are also available at the office and may be completed upon your arrival. 


Health Insurance

Please call our office if you have any questions.

RO kindly reminds you to bring all of your insurance information and driver's license to your appointment.

We accept the following Health Insurance:






Community Giving

Ridgefield Ophthalmology has proudly supported the following organizations:

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Ridgefield Public Schools

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Run Like a Mother

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Boys and Girls Club of Ridgefield

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Founders Hall

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Ridgefield Chamber of Commerce

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Ridgefield Library

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Ridgefield Operation for Animal Rescue (ROAR)

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Locks of Love


Patient Testimonials


Thank you so much for the exceptional care you and your staff have given me and my family for routine and emergency eye care. Over the past year you’ve treated me and each of my three young children for various ailments, including eye infections, a scratched cornea, and surgical repair of facial lacerations. You provided the best of care in a comfortable and relaxed manner making difficult situations much more manageable. You have shown true dedication to your patients by being available evenings and holidays in order to provide emergency and ongoing care. I was amazed and immensely grateful when you delayed your family vacation so that you would be able to personally follow my son’s recovery from a scratched cornea. Thank you again for the excellent medical care you have provided to my family