Online Forms

At Eyetopia Optometry, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

• You will need AdobeReader® to download and complete the forms.
• Download the required form(s). Print out the form(s) and complete the required information.
• Fax your printed and completed form(s) to our office or bring them with you to your appointment.

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NEW PATIENTS: Please print and fill out the Welcome Form and Medical/Vision History Forms on this page to expedite your exam.

Welcome Form

Please sign and date forms and remember to bring them with you to your appointment.

Download & Print Form

Medical and Vision History Forms

Please review our office’s Privacy Practices, which is in compliance with HIPAA (Health Insurance Portability and Accountability Act) and sign and date the consent form to bring with you to your appointment.

Download & Print Form

Notice of Privacy Practice

Download & Print Form

Insurance and Privacy Policies Consent

Download & Print Form

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Download the Free AdobeReader®