Patient Information
As a new patient, if you did not receive our welcome packet, please either use the online forms OR download the medical history and patient information forms, print them on your printer, and fill them out. Please bring them with you on your visit to save you a little time in the office.
Online Forms:
Child Medical History Form (age 17 and younger)
Adult Medical History Form (age 18 and older)
Download Both Medical History Form and Patient Information:
Adult Medical History Form (age 18 and above)
Child Medical History Form (age 17 and under)
Patient Demographic Information
HIPAA
Trusted Information Resources
American Academy of Ophthalmology
Ohio Amblyope Registry
EyeSmart