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Online Forms

Preparing for your visit

Please bring your current eyeglasses and/or contact lens boxes (with the prescription tab), along with an updated list of medications.

We will need a copy of your insurance card and drivers license.

If you are a new patient, please consider the following two options.

     Online Forms

You may conveniently fill-out or up-date your patient information including all MEDICAL history online by the following link:

     Paper Forms

Alternately, you may print the following forms to fill out & bring them with you to your upcoming appointment.

New Patient History - /storage/app/media/Entrance_Form_Eyecare_Rockwall.pdf

Contact Lens Service Agreement - /storage/app/media/Contact_Lens_Service_Agreement_RE.pdf

Office Policies Signature Form - /storage/app/media/Office_Policies_Signature_Form.pdf

COVID-19 Patient Disclosures covid-patient-disclosure.pdf

Other Forms

Pediatrics Eye Examination Questionnaire - /storage/app/media/Pediatrics_Exam_Questionnaire.pdf

Developmental Questionnaire for Children - /storage/app/media/Developmental_Exam_Questionnaire.pdf

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