Patient Forms

Save time on your first visit!

Print out and complete these forms before you arrive for your appointment.

Complete Patient Packet

• Patient Forms Packet (5 pages)
• HIPAA Notice of Privacy Practices (5 pages – print for your records)

Individual Forms

If you need an individual form, please chose from the list below.

• Demographic Form
• Medical History Form
• Dilating Eye Drops Authorization Form
• Medical Records Release
• HIPAA Notice of Privacy Practices

NOTE: You will need Adobe® Acrobat® Reader™ to view and print documents with the PDF logo.

If you do not have a current version of Adobe Acrobat Reader installed on your computer, please click on the Acrobat Reader link, download and install the Adobe software. This is free and easy to install software that lets you view and print Portable Document Format (PDF) files.