patient intake form

Important Privacy Notice

To help save time on the day of your appointment, you may download and complete our new patient forms, including the First-Time Patient Form, in advance.

Please be aware: Email is not a fully secure method of communication. If you choose to send completed eye exam forms to us by email, there is a potential risk that personal health information (PHI) could be intercepted or accessed by unauthorized parties while in transit. By emailing your patient intake form to us, you acknowledge and accept this risk.

If you prefer not to transmit your information electronically, we recommend that you print the completed form and bring it with you in person on the day of your exam.

We take patient privacy seriously and handle all personal and health information in accordance with applicable privacy legislation. If you have any questions about submitting your forms or would like to discuss alternative options, please contact our office prior to your appointment.