New Patient Forms

Please print form, complete and bring to your next office visit.

• Eye Health History Form
• Sensory History Form
• Financial Policy Form
• HIPPA - Notice of Privacy Practices Form

Other Patient Forms

• Release of Records
• Answers to Your Questions
• Progress Evaluation - Children
• Progress Evaluation - Adults
• OD Vision Therapy Referral

Note: All forms are viewed through Acrobat Reader.