Patient Forms

Be prepared for your exam with us or find out more about your potential eyecare needs.

Before You Visit

Health History

Please complete this form before your visit in order to save time at check-in.

Childrens Health History

Please complete this form for your child before your visit in order to save time at check-in.

Privacy Policy

These are our policies regarding your personal information. 

Diagnostic Tests

Visual Performance Checklist

Use this checklist to help us evaluate the Visual Performance and Quality of Life of the taker. 

Convergence Insufficiency Checklist

Use this checklist to help us evaluate whether the taker suffers from Convergence Insufficiency.