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Patient Forms

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

Before You Visit

Health History

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

Childrens Health History

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

Privacy Policy

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These are our policies regarding your personal information. 

Diagnostic Tests

Visual Performance Checklist

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

Convergence Insufficiency Checklist

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

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