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Patient Information

Four Seasons Eye Care strives to make comprehensive eye care convenient for its patients. We look forward to serving you. To maximize your Four Seasons Eye Care experience, please follow these steps:

  • New Patients (only): Fill out and bring the Patient Information and Health History Form
  • Contact your insurance provider or review your plan documentation to confirm the benefits offered by your health plan, co-pay amounts, or if referral authorization is needed
  • Bring your insurance card with you to appointment
  • Bring a list of current medications
  • Bring eyeglasses prescription, if not prescribed at our offices
  • Bring form of payment for any co-pays (Cash, Checks, Credit Cards are all excepted)

New Patient Forms

New patients are asked to download and print off the below forms, and bring these with you on your visit. We look forward to meeting you.

Patient Information
Health History
Vision Therapy Form


Four Seasons Eye Care participates in many insurance plans and will submit claims on your behalf, as allowed by your health insurance company. Because health insurance plan payments vary and benefit levels are unique to each plan, you should confirm out of pocket cost with your insurance carrier by calling the number on the back of your insurance card.

Here is a general list of insurance companies we work with, though not all inclusive. If you have additional questions, or do not see your insurance company listed here, please contact our Business Office at (763) 746-3391.

  • Aetna
  • Blue Cross & Blue Shield
  • Cigna
  • Health Partners
  • Humana (only Medicare Advantage Plan Humana Choice and Gold Choice)
  • Medicaid, MN Care and most Prepaid Medical Assistance Plans
  • Medica
  • Medicare
  • Preferred One
  • Preferred One Administrative Services
  • Select Care
  • Tri Care for Life
  • Tri West
  • UCare
  • UMR
  • United Health Care
  • VSP (Vision Service Plan) Premier Provider

Please note: Your policy may have additional policy requirements, such as authorizations, referrals or coverage restrictions that may impact the final reimbursement of your claim. Please verify your coverage by calling the number on the back of your insurance card, or refer to your plan summary documents for additional details on your policy.