Patient Forms and Policies


Preparing Your Forms

To save you time at your first appointment, our patient forms are available here for download. We recommend that you print and complete each form before arriving. Simply click each form below to access the document.

These forms are also available on our secure Patient Portal. If you are using the Patient Portal, the forms may be emailed to our office prior to your visit.

You may call our office if you have any questions while completing your forms.

Remember to bring:

1)  Your Insurance Card(s)
2)  Your valid Driver's License or Photo ID
3)  List of All Medications you are currently taking
4)  Your Eyeglasses and/or Contact Lenses that you currently use

We look forward to providing you with quality eye care, from your examination to all of your optical needs!

Patient Information Form   Patient Information
Patient Medical History Form   Medical History
Refraction Form   Refraction Form
Acknowledgement of Policies Form   Policies Form
RecordsRelease1   Records Release
PrivacyPolicy1   Privacy Policy

Privacy Policy

Our Patient Information form makes reference to your acknowledgment of our Privacy Policy (HIPAA). Please take a few minutes to read this policy. A PDF version of our Privacy Policy brochure is available above. Click on the cover image to view the brochure document.