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Black Hills Regional Eye Institute
2800 Third Street
Rapid City, SD 57701
Toll Free: (800) 658-3500
Click For Map & Directions 
| File | Description | Download |
|---|---|---|
| Employment Application | If interested in employment at Black Hills Regional Eye Institute, please download this application and return to 2800 3rd Street, Rapid City. Application can also be emailed to bhreiadm@bhrei.com or faxed to 605-719-3211. | Download |
| New Patient Forms | Please click on the 24/7 icon in the upper right corner of our home page to register online. |
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| Medical Records Release Form | If you would like a copy of your records or need a copy sent to a doctor's office, please fill out this form and return to the Eye Institute. | Download |
| Patient Registration Form | Please click on the 24/7 icon in the upper right corner of our home page to register online. |
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| Medical History Questionnaire | Please click on the 24/7 icon in the upper right corner of our home page to register online. |
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| Fax Referral Form for OD | If you are an optometrist and are referring a patient to the Black Hills Regional Eye Institute, please complete this form and fax to the Eye Institute. | Download |
| Eye Institute Information | This form includes general information about the Eye Institute including medical staff, doctor services, hours, appointments, policies, fees, insurance, and medicare. | Download |
| Eye Institute Map | Use this map if you need directions to the Black Hills Regional Eye Institute. | Download |
| PRK Post-op Form | If you are a doctor's office caring for a PRK patient from the Black Hills Regional Eye Institute, please use this PRK post-op form. | Download |
| Cataract Post-op Form | If you are a doctor's office caring for a cataract patient from the Black Hills Regional Eye Institute, please use this cataract post-op form. | Download |
| Cataract Surgery Drop Instructions | This form provides drop instructions for cataract surgery patients. | Download |
| LASIK Post-op Form | If you are a doctor's office caring for a LASIK patient from the Black Hills Regional Eye Institute, please use this LASIK post-op form. | Download |
| LASIK Pre-op Form | If you are a doctor's office caring for a LASIK patient from the Black Hills Regional Eye Institute, please use this pre-op form. | Download |
| Diagnostic Testing Form | If you are a doctor's office referring a patient for a diagnostic test at the Black Hills Regional Eye Institute, please use this form. |
Download |
| Hotel Listing | Many hotels in Rapid City provide medical discounts for our patients. Please review this form for participating hotels. | Download |
| HIPAA Policy | This form outlines the HIPAA Policy at Black Hills Regional Eye Institute. | Download |