Pediatric Medical History Form for new patients – PDF
After reading the HIPPA privacy statement we ask that you print this acknowlegment out and sign it. When you arrive for your inital appointment please bring a signed copy to the office . By law, we must keep it on file as a part of your medical record.
HIPPA Privacy Acknowlegment – PDF
This form would be used if you would like us to transfer your records to another doctors office.
Medical Records Release Form – PDF
Download this PDF to view the fiull warranty information we give out with every pair of glasses we sell.
Optical Warranty Information – PDF
Please fill this form out and bring it to your first appointment.