Phone: 601-957-6078

Patient Registration

At Rogers Family Eye Care, we value your time. In an effort to save you time in our office, you can access your patient registration forms via our online patient registration portal online or by downloading and completing our patient form(s) prior to your appointment. These forms will let us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form.

Printed Patient Registration Forms

You will need AdobeReader® to download and complete the forms. Click here to download.

Download the required form(s). Print out the form(s) and complete the required information.

Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Participating Insurances

  • Aetna
  • Ambetter
  • BCBS
  • Blue FEP
  • Cigna Medical
  • Emdeon Vision
  • Envolve Vision
  • Eyemed
  • Guardian- Avesis
  • Humana Medicare
  • Humana VCP
  • Humana
  • Magnolia Chips/CAN
  • Medicaid
  • Medicare
  • Molina Healthcare
  • National Vision Administrators – NVA
  • March Vision
  • Superior Vision
  • UHC Chips and MS CAN
  • United Health Vision
  • WellCare

Payment Options

Rogers Family Eye Care accepts: cash, check, and all major credit and debit cards.

Additional Plans

We also accept Flexible Spending Plans, Medical Savings Accounts (MSA), and Health Savings Accounts (HSA). All of these plans can be used to purchase our services and products including eye exams and contact lenses

Care Credit

CareCredit helps you pay for out-of-pocket healthcare expenses for you, your family, and even your pets! Once you are approved, you can use it over and over again to help manage health, wellness and beauty costs not covered by insurance.

To learn more or apply for the card, visit Care Credit here.

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