Janigian Retina Associates - AMD Center of Excellence Award

Patient Forms

Woman at office desk

Welcome to Janigian Retina Associates. Prior to your appointment, please request a referral or authorization from your primary care physician, if you have an insurance policy which requires prior authorizations, such as an HMO. Your primary care physician needs to fax us the necessary information to 401-369- 7336 before your scheduled appointment.

What to bring to your appointment:

  • The Patient Registration form (completed) Health Insurance ID Card(s)
  • Any Co-payment required by your insurance carrier Your current glasses, distance and reading
  • A list of all medications you are taking

What to expect on your first visit:

You can expect to be in the office for a minimum of 1-2 hours. You may spend more time if there is a need for you to have testing. Please be aware that your eyes will be dilated. If you have diabetes, please bring a snack with you.

If you have any questions about your appointment or if you need to change your appointment, please call the office at (401) 369-7773. We thank you for trusting Janigian Retina Associates with your care.

Please click the buttons below to download the forms:

Patient Registration

Payment Policy

Privacy Policy Consent

Uveitis History

Confidentiality Release

Our Locations

Providence

120 Dudley Street, Suite 303
Providence, RI, 02905

Tel: 401-369-7773Fax: 401-369-7336
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Wakefield

46 Holley Street, Suite 1A
Wakefield, RI 02879

Tel: 401-284-1737Fax: 401-284-3286
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Middletown

939 West Main Road
Middletown, RI 02842

Tel: 401-846-1946Fax: 401-369-7336
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Johnston

1524 Atwood Avenue, Suite 240
Johnston, RI 02919

Tel: 401-369-7773Fax: 401-369-7336
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Cumberland

2138 Mendon Road, Suite 101B
Cumberland, RI 02864

Tel: 401-205-1759Fax: 401-205-1810
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