Forms

Every new patient and returning patients who have had a change in address or phone number must fill this form out at the oce or bring in a completed form. Please remember to sign and date the second page.

Every patient must fill this form out at least once a year.

Every new patient must fill this form out. Returning patients only need to complete this form if they have not done so before. Before signing this form, please read our Privacy Practices.

A full medical history is required not only by insurance companies, but also by the doctor, in order to best treat you. We ask that you complete one of these forms if you are a new patient, or are coming in for your regular eye exam.

This form only needs to be filled out if you would like to authorize our office to acquire records from another practitioner or if you need us to send your records to other practitioners.