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Forms
| 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 on our home page to register online. | |
| 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 on our home page to register online. | |
| Medical History Questionnaire | Please click on the 24/7 icon in the upper right corner of our home page to register online. | |
| 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 |
Recent Posts
Dr. Steve Khachikian Offers Hope May 21st 2013
Implantable Telescope Helps Those with May 21st 2013
Live LASIK Surgery May 13th 2013
How Successful Is LASIK? May 11th 2013
Visual Errors Corrected by LASIK May 02nd 2013
Watch Live LASIK Surgery and May 01st 2013
On LASIK Safety - What Apr 11th 2013
Optical Works to Host Trunk Mar 25th 2013
The Advantages of LASIK Mar 21st 2013
Eye Institute Honors and Celebrates Mar 19th 2013