Online Forms

New Patient Packet

Download & Print Form

Lifestyle Questionnaire

Download & Print Form

Blinking Exercises

Download & Print Form

Dry Eye Heat Mask Instructions

Download & Print Form

Records Release / Request Form

Download & Print Form

If you have any questions, please do not hesitate to contact our office by calling (228) 328-0972.

Initial Consultations / Exams

Your initial appointment will consist of a consultation and eye exam.  Dr. Benefield and Dr. Walker will explain your diagnosis and treatment options and answer any questions you may have.  Please plan to arrive 10 minutes early for your appointment. If you are getting a complete exam, your eyes may be dilated and you will need someone with you to drive you home.

Scheduling Your Appointment

We are open Monday - Thursday from 8:30 a.m. - 5:30 p.m. and Friday 8:30 a.m. - 4:30 p.m. We will schedule your appointment as promptly as possible. If you have an emergency situation, every attempt will be made to see you that day. We try our best to stay on schedule to minimize your waiting. Due to the fact that our physicians provide many types of services, including emergencies, various circumstances may lengthen the time allocated for an exam or procedure.  Thank you for choosing Benefield Eye Care and Coastal Eye Surgery Center.

Affordability & Payment Options

When considering a vision correction procedure, financial considerations should not be an obstacle in obtaining the eye care you deserve. We offer Care Credit Financial and Alphaeon Credit as a financing option for your procedure. This convenient, affordable way of paying for your procedure is a great option, so you don't have to delay enjoying the best vision possible for your active lifestyle. Our office staff will be happy to help you with any questions and to file your medical insurance claims for you.  Participating insurance plans included but not limited to: Medicare, Blue Cross Blue Shields, Aetna, Cigna, Humana, United Health Care, SAS, VSP, and Always Care. 

Call us today at (228) 328-0972.328.0972 for questions or to schedule your appointment.

To better serve our patients Benefield Eye Care provides the following helpful patient forms below.

At Benefield Eye Care, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReaderĀ® to download and complete the forms. Download the Free AdobeReaderĀ®
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Contact Us

We look forward to hearing from you.


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Hours of Operation

Our Regular Schedule

Gulfport Office

Monday - Thursday:

8:30 am - 5:30 pm


8:30 am - 4:30 pm

Saturday, Sunday:


Coastal Eye Surgery Center Office

Monday, Tuesday, Thursday:

8:30 am - 4:30 pm


7:00 am - 4:30 pm


8:30 am - 12:00 pm

Saturday, Sunday: