Patient forms

Patient Forms

Save time during your visit by downloading and completing our patient forms in advance. Bring completed forms to your appointment or submit them through our patient portal.

Submit Forms Online

Downloadable Forms

Click on any form to download a printable PDF version.

New Patients

New Patient Registration

Required

Complete patient information form including personal details, emergency contacts, and medical history.

Medical History Questionnaire

Required

Detailed health history including current medications, allergies, and family eye history.

HIPAA Privacy Notice

Required

Acknowledgment of our privacy practices and how we protect your health information.

Insurance Information Form

Insurance policy details and authorization to bill your insurance company.

Contact Lens Patients

Contact Lens History

Previous contact lens wear history and current lens specifications if applicable.

Contact Lens Agreement

Agreement for contact lens wear, care instructions, and follow-up requirements.

Pediatric Patients

Minor Child Consent

Parental consent form for examination and treatment of patients under 18.

Records

Medical Records Release

Authorization to release or request medical records from other providers.

Print & Complete at Home

  1. 1Download the required forms
  2. 2Print and fill out completely
  3. 3Sign and date where indicated
  4. 4Bring completed forms to your appointment

Complete Online via Portal

  1. 1Log in or create a patient portal account
  2. 2Navigate to "Forms" section
  3. 3Complete forms electronically
  4. 4Submit securely before your visit
Access Patient Portal

Tips for Completing Your Forms

Complete All Fields

Fill in all applicable fields. Write N/A for questions that don't apply to you.

List All Medications

Include prescription medications, over-the-counter drugs, vitamins, and supplements.

Know Your Family History

Eye conditions can be hereditary. Know if family members have glaucoma, macular degeneration, etc.

Bring Insurance Cards

Have your medical and vision insurance cards available to copy down policy numbers accurately.

Your Privacy is Protected

All patient information is kept confidential in accordance with HIPAA regulations.

View HIPAA Notice

Ready for Your Appointment?

Download your forms, then schedule your appointment online or give us a call.