Have Your Records Sent to RidgeView

I authorize the above-named provider/entity to release the following designated medical information.

Information to be Released

Copy of complete medical records including results of diagnostic testingCopy of contact lens prescriptionCopy of spectacle lens prescriptionInsurance information

Requesting records from the office of

I, authorize the release of my eye exam records to be released to:

Dr. S. Matthew Buchanan at RidgeView Optometry 8540 Scarborough Dr. Ste 240, Colorado Springs, CO 80920

Please fax my records to (719) 282-3081.

If you have any questions, please call (719) 495-5904. Thank you

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8540 Scarborough Dr, Ste 240
Colorado Springs, CO 80920

Call Us Today:
(719) 495-5904

MON 8:00am - 5:00pm
TUE-FRI 8:00am - 5:30pm
SAT-SUN Closed

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