Pediatric & Adult Ophthalmology
Specialty Eye Care With A Family-Friendly Approach

New Patient Forms

There are THREE forms that all new patients are required to complete for our office. 

Bring all three completed forms with you to your appointment. 

We ask that you bring your insurance card(s) to your appointment so that we may make a copy for our records.  If you wear eye glasses (including reading glasses) or contact lenses, please bring them.  For contact lens wearers, please bring the box that your contact lenses came in.  If you are currently taking any eye drops, please bring them as well.

These forms will require Adobe Acrobat (free program) to open, view and print them.


Registration Form
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Medical History
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Refraction Fee & No Show Policy
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