Patient Forms
If you are a new or returning patient please fill out page 1, 2, 3 and bring to your GENERAL EYE EXAM appointment. COVID-19 Patient Questions has been added recently as an extra precaution. PLEASE FILL OUT ONLY PG 3 if you are coming into the office starting 3/16/2020 for any follow ups/ brief visits. Thank you for your understanding.
| Patient Questionaire pg1 .pdf |
| Patient Questionaire pg2 .pdf |
| COVID-19 Patient Screening Questions pg3. pdf |
| Notice of Privacy Practices .pdf |
| Optomap Info.pdf |
| Release of Records Request.pdf |