| Online Form

Printable History Forms






General Office Forms


Print Follow-up Forms


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Welcome
to our Online Forms Page
We have provided you a
way to access our medical history forms online so you
can save time when it is time for you or your child's
appointment. If you are an existing patient scroll to
the bottom.
New Patients
Follow
these three easy steps before coming to our office:
-
After you have called
our office to schedule an appointment for your child,
please click on the "Child
History Form" link to the left
and follow the directions for a new or existing
patient. This gives you an opportunity to tell us
about your child in great depth. Included in this form
is information about school aged children from
pre-school up to high school. Please answer the
questions that are appropriate to your child.
You are welcome to skip any that you do not know.
We will be able to fully address all of your needs and
concerns with this information.
This information is completely secure and stored on
our practice
management software's server.
NOTE: If you are coming
in for an Infant
Vision/Adult
Vision Evaluation/Brain
Injury Vision Exam
or are uncomfortable with
sending your child's information over the internet,
please print the appropriate form located under
Printable Forms to the left, fill it out completely,
and bring it with you to the appointment.
-
If you need records
sent to us, please print the
"Records
Release Form," fill it out, and
fax it to your previous or referring doctor.
-
All patients must consent to our
privacy policies. You will be asked to sign a consent
form when you arrive for you or your child's
appointment. You may print this in advance, sign the
last page, and bring it into our office to save time.
In order to review our privacy practices, please click
on the "Privacy
Policies" link to the left.
This information
is very helpful to have ahead of time and we
appreciate you filling it out well in advance of your
appointment.
Existing Patients
If you are coming in for
a follow-up visit, please click on the appropriate link
to the left under print follow-up forms.
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