Forms

Thank you for visiting our website! This is the central location for forms that may be completed before visiting our office.  If you have any questions, please do not hesitate to call our office at (850) 671-5558.

New Patient Forms

Below are the three forms that our office uses to create your chart.  Please print and complete these three forms prior to your first visit and give them to the receptionist when you enter. Your cooperation is greatly appreciated, and it will help us to see you more quickly.

Patient Information Sheet

Refraction Policy

Patient History Form

Medical Records Release Forms

If you would like a copy of your medical records from our office, please print, complete this form in the presence of a witness, and mail, fax, or bring this document in to our office.

Records Release Form