Patient Information


Ullman Eye Consultants is a participating Medicare provider. We accept Medicare assignment, and as a courtesy, will file with your secondary insurance if applicable.

We are also participating providers with many major medical insurance plans, including selected plans from:

  • Medicare
  • Railroad Medicare
  • Blue Cross / Blue Shield of Florida (many plans)
  • Blue Cross / Blue Shield of Alabama PPO
  • United Healthcare PPO
  • Aetna PPO
  • Tricare Standard
  • Humana Choice Care PPO
  • Cigna PPO

This is just a small sample of plans that we participate in. Please contact us at 850-208-1900 to see if we participate in your particular insurance plan or if you have any other insurance questions. If you are in an HMO or PPO co-payment is expected at the time of service. It is the patient’s responsibility to obtain the necessary referrals and / or authorizations. It is ultimately your responsibility to know what insurance coverage you have and what authorizations are necessary. Our office will assist you whenever possible.


5528 N. DAVIS HWY.


Step 1:
If you have Adobe Acrobat Reader you may skip to step two. If you do not have Adobe Acrobat Reader or are unsure, click the ‘Download PDF Reader’ link below this text. This will take you to the Adobe Reader Download site. Follow their instructions to install the necessary reader.

Download PDF Reader

Step 2:
Next click on the ‘Read HIPAA Form’. You do not need print this but it is essential that you read it before signing the last office form below.

Read HIPAA Form

Step 3:
Now click the ‘Download Office Forms’ button below this text. Click ‘Save’ on the window and select where you would like to save the file. Then, when the download is complete, open the file. This should open Adobe Acrobat Reader containing the Ullman Eye Consultants’ office forms.

Download Office Forms

Step 4:
Now your third and final step is to simply push the ‘Print Button’ in Adobe Acrobat. A picture of the button can be found below this text. Then, fill out the forms and bring them in on your visit.

Please open which button below, and print the documents so you can bring them with you to your visit.