Available Forms
Surency Vision available forms
Below is a list of links to important forms. After selecting a link, use your web browser or PDF File/Print option to print the form. If you have questions or need additional information, please contact our customer service representatives at (866) 818-8805.
Out-of-Network Claim Form      

Visiting an out of network provider? Use this form to submit your claim to EyeMed Vision Care.

 
Find a Network Provider  
By visiting a Surency Vision provider within the EyeMed Network you can significantly increase your benefit coverage. Search for an in-network provider by location, retail name, provider last name, or distance.  
   
   
   
   

Notice of Privacy Practices
 Click to View Surency's Notice of Privacy Practices

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