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Patient Forms


The following forms are in Adobe Acrobat PDF Format. If you do not currently have Adobe Acrobat software, it is available for download at no cost on the Internet. Download Acrobat Reader 

Adult Forms (PDF):

New patient information

New Patient Registration Form 

Refraction waiver

Health history


Pediatric Forms:

Pediatric Patient Registration Form 

Pediatric Health History Form

Miscellaneous Forms:

Minor Child Medical/Surgical Treatment Authorization Form

Protected Health Information Authorization Form

Authorization to Obtain and/or Release Records



Privacy Practices

Privacy Practices

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