You may print and fill out these forms to help speed up your check-in time at your next appointment.
Please click on the image below to view our patient information book.
Patient Information Form
Medical History Form
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.
Financial Policy for Patients
Please take a moment to review our Financial Policy. If you have any questions please call 605-341-2000
This form outlines the HIPAA Policy at Black Hills Regional Eye Institute.
Notice of Medical Information Privacy Rights
Patients Bill Of Rights
Rapid City Hotel Listing
Eye Institute Map – Rapid City Location