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Patient Forms

To ease your check-in process, you may print the following PDF forms on a computer and fill them out at your convenience prior to your comprehensive eye exam.

Acknowledgement of Receipt
Authorization to Share Protected Health Information with an Individual(s)
Children's Health History Form
Notice of Privacy Policies
Financial Policy
Health History Form
Records Release Form

In addition, please bring the following with you to your scheduled appointment:

  • Driver's license
  • Insurance cards
  • Medication list (name, dosage)
  • Current glasses, if applicable

Be ready to discuss any issues with your eyes or vision problems. We look forward to your visit.