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Patient Center

Online Forms

Please use the links below to download printable PDF versions of our patient forms, and bring them with you on your visit to our offices:

Contact Lens Fees - Download & Print

Privacy Practices - Download & Print

Optomap and M-Pod Consent Form - Download & Print

Patient General Information - Download & Print

Patient Medical History Form - Download & Print

Patient Consent to Release Information - Download & Print


As a service to our patients, Kennedy Vision Health Center is pleased to offer the CareCredit card, North America’s leading patient payment program. CareCredit has a full range of payment plans to meet every financing need, including no interest and low interest options.

No Interest Payment Plans

Extended Payment Plans


Payment Options

At Kennedy Vision Health Center, our mission is to provide quality service and products at reasonable pricing. We accept the following payment methods:

  • Cash
  • Check
  • Visa, MasterCard, American Express and Discover
  • Flexible Spending Plans
  • Health Savings Accounts (HSA)

Participating Insurances

Kennedy Vision Health Center submits to the insurance carriers listed below. If you don't see your insurance carrier listed, contact us at (763) 545-8850 to see if the carrier has recently been added. We also accept patients who want to self-pay for their exam. If we do not carry your insurance or vision plan we will give a discount on services and/or products.

  • Aetna
  • Allina
  • Advantage Plan
  • Selectcare PPO
  • Blue Cross Blue Shield
  • Medica Medicare
  • Cigna
  • Comprehensive Care Services
  • LaborCare
  • Coventry Health Plan
  • Definity Health Plan
  • Great West Health Plan
  • United Healthcare Options PPO
  • Health Partners
  • Humana
  • Medicare

  • Medicare BCBS PPO
  • Medica
  • Patient Choice
  • Medica Choice/Medica Self-Insured
  • Preferred One
  • Medica MIC Choice
  • Select Care
  • TriCare
  • Medica Elect
  • U Care
  • Medica Premier
  • United Health Care
  • Medica Choice Care & Medica
  • Minnesota Care
  • (VSP) Vision Service Plan


Carriers listed are organizations that Kennedy Vision Health Center submits claims too. Submitting a claim does not guarantee coverage. Be sure to check with your insurance carrier for specific coverage levels.

  • Discounts are only given if the payment is made on the day of service
  • A 20% discount is given for patients with EyeMed, Spectara, or Davis Vision Plans

Corporate Accounts:

Kennedy Vision Health Center has corporate account relationships with the following organizations. If your organization is interested in opening a corporate account with us, call (763) 545-8850.

  • Honeywell
  • Progress Casting
  • Sifco Custom Machining

We are closing our office due to the COVID-19 situation. Starting Monday we will only be seeing emergencies and have one staff at the office to deal with pickups.

Plymouth 9-5 pm M-F
Elk River 8-12 pm M-F

We are asking patients to schedule pickups and call when they arrive at the clinic and a staff member will deliver curbside.

We hope to open again on April 6th but that will depend on the situation.