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Below are some of the forms that will need to be completed prior to beginning our program. Simply download the form that pertains to you, fill it out completely, and turn in at your consultation or upload below. We have also included an evaluation form in which you can grade yourself, or child (please bring ALL completed form to your scheduled appointment).

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

New Patient Form (Adult)

New Patient Form (Child)

Traumatic Brain Injury

Download the Free AdobeReader®