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Patient Forms

Please feel free to download any of these forms that may apply to you. You may print them, fill them out in advance of your appointment, and bring them with you to your visit. This may help expedite your stay in the office.

New Patient Forms

• DEA Privacy Summary
• Patient History Questionnaire
• Patient Registration Form
• Eye Dilating Drop Consent
• Refraction Consent Form

Annual Update Forms

• DEA Privacy Summary
• Secondary Patient Registration Form
• Eye Dilating Drop Consent

Credit Card Authorization Forms

• Credit Card Authorization Form
• Contact Lens Credit Card Authorization

DMV Forms

• DMV Complete Form
• DMV Short Form (use this form only if vision 20/40 or better an no serious eye problems)

Release of Medical Records

• Release of Medical Records from DEA
• Release of Medical Records to DEA