1.800.EYECARE

Schedule An Appointment

1.800.EYECARE

Medical & Patient Forms

To expedite your visit, please bring in a completed copy of our medical and patient forms to your scheduled appointment.

English Forms:

pdf-icon Patient Information Form
pdf-icon Medical History Form
pdf-icon Patient Contact and PHI Information Form
pdf-icon Well Vision Form

En Español:

pdf-icon Información Para Pacientes
pdf-icon Historia Clinica
pdf-icon Información Para Pacientes Insurance y Contacto
pdf-icon Información Para el Examen de los Ojos Saludables

What our customers are saying:

The staff made me feel extremely comfortable and even though they see many patients, they never made my questions or anxiety feel silly. They answered all my questions and continue to. Overall a wonderful experience.

- Shandin

You guys were very accommodating!  Surgery went very smooth and you all are so professional and sweet! Thank you.

- Jaclyn H

The staff was absolutely amazing and very helpful with everything. All my questions were answered. I highly recommend Nationwide Vision Laser and Medical Eye Center for anyone considering LASIK.

- Nada D