Patient Forms
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When you click the "Complete Patient Form" button, you'll see the login page. (If this is your first visit, we'll take a few seconds to help you create a login to our site.)
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Welcome Forms |
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New Appointment Patient Instructions
The Welcome Form is the first form you’ll want to read to get ready for your appointment. It gives you step by step instructions for completing all of the necessary forms for yourself and a loved one. |
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Confidential Medical History & Review of Systems
Complete this form online by clicking the "Complete Patient Form" tab above. Since many general health conditions may be associated with eye problems, this important form will allow us to care for you as a “whole person” rather than just a pair of eyes. This form contains a section for prescription and nonprescription medication. If you prefer, a separate list may be brought with you for us to photocopy and keep with your records. |
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Patient Registration Form
Complete this form online by clicking the "Complete Patient Form" tab above. This sheet supplies us with your demographic and insurance information. On the day of your appointment, please bring both your medical (health) insurance card and your routine vision plan card and benefit information that identifies coverage for the exam, eyeglasses and contact lenses. |
Infant and Pediatric Forms |
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The InfantSEE® Program Registration
For children ages 6 months - 12 months |
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Pediatric Medical History Form
For children ages greater than 12 months - 2 years |
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