New Patient Form

Prior to your visit, it would help our clinical staff if you take a minute and complete this form. Either print the form out and bring it with you, or please email to us prior to your visit. Additionally, our staff will try to remind you of this form at check-in. It will help our team understand more about you and help us tailor your visit to answer your questions.

The following is a general information form about you, your past medical history, and medical/vision insurance information.

New Patient Demographic Form
woman getting eye exam