Patient Forms

To ensure a smooth first visit, we encourage you to complete your patient forms before arriving. You will receive these electronically with a texted link from Phreesia. If you do not receive this text, you can also download, print, and fill out the forms at your convenience. Bringing these forms to your appointment helps us provide you with the focused, one-on-one care you deserve.

Patient History Form – English
Refraction Fees – English
Parental Pre-Authorization Form – English
Privacy Policy Form – English
Patient History Form – Spanish
Refraction Fees – Spanish
Parental Pre-Authorization Form – Spanish
Privacy Policy Form – Spanish

*These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo to download.

Thank you for choosing Professional Eye Associates. We can’t wait to meet you!