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Forms

Eye Exam Appointments

New and returning patients can now Book Eye Exams online! Click the Appointment Request Form below – it is secure and HIPAA compliant.

New Patient Forms

Are you a new patient? You can save time in our office by printing these forms. Click the image below to download the forms.

  • Welcome Form
  • Insurance Release
  • Release of Information Authorization
  • Vision and Learning Assessment (Kindergarten through College Students)

Click to download New Patient Forms

Vision Therapy Assessment Referral Form

  • Section 1: Referring Healthcare Provider

  • Section 2: Patient Information

  • Refraction & BCVA:
  • Refraction & BCVA: