Patient History Questionnaire, please complete the entire form and bring it to your appointment. This will give you the opportunity to gather accurate information and save you time the day of your appointment.

Print special coupon for savings.

If you wear contact lenses and have never had a contact lens exam in our office, please complete this form and bring the completed form to the office on the day of your appointment.

Sometimes it is necessary to have more than one examination. If you wear contact lenses or are interested in contact lenses, please read and sign this form and bring it to your appointment.