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Patient Information Form

New or Existing Patients

Please click here and complete the form before your first office visit or eye exam.

This will save you time and make the office administration process easier.

The Health of Your Eye

During your exam we will check the health of your eyes either by dilating your eyes with eye drops and/or with the Optomap retinal imaging.

Dilation is included in the exam price, but be prepared for light sensitivity and near blur for about 4 hours. Remember to bring sunwear and/or a driver.

Optomap is the doctors preferred method and a convenient alternative that has no lasting side effects. It provides a digital image that can be used to track the history of your eye health. This service is offered for an additional $35.00. Click here for more information on Optomap retinal imaging.

We look forward to seeing you for your eye exam. To help us serve you better, please bring with you current glasses, sunwear, and/or contact lens information. Also a picture ID, insurance cards, and medication lists. Thank you!


If you have any problems or questions please contact us at 541-389-4774.