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Online Forms

At our office, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReaderĀ® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office at (812)477-1874, or bring them with you to your appointment.

Patient Information Form

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

New Patient Information Form[Download & Print Form]

Our Privacy Policy [Download & Print Form]


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