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New Patient Forms

Instructions

Please print out the appropriate FORMS for your case (or as many cases apply if you're applying for more than one person). You will need the age-appropriate "Information Packet" along with the accompanying age-appropriate "Medical History."

Ages 0 - 12

  • "Child" Information Packet plus the "Child" Medical History Forms

Ages 13 - 17

  • "Young Adult" Information Packet plus the "Young Adult" Medical History Forms

Ages 18+

  • "Adult" Information Packet plus the "Adult" Medical History Forms

Please bring your filled-out form to your appointment.

Please take a moment to read our Privacy Practices, and then sign and date the HIPAA Privacy Policy section in the Information Packet.

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Child Info

Child History

Young Adult Info
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Young Adult History

Adult Info

Adult History
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Privacy

    
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80% of what we learn depends on the efficiency of the visual system. “20/20” eyesight is only a very small part of good vision.