This form allows us to gather your medical history so that we are able to meet all your vision needs. Welcome Back! Please fill this form to update your information if you are an existing patient at our practice. New and current patients- please fill this form out for pupil dilation. This is included in your comprehensive exam at no extra charge. New and current patients- please sign this form. (The HIPPA policy can be found on the bottom of this page.) New and current patients- please complete form if you would like to have a contact lens fitting exam.
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