Please complete the form, and then click on the 'Submit' button to send the information electronically to our office.
The 'Patient Information Form' is required 48 hours prior to your annual eye exam appointment.
- Merritt Island Patient Information Form
- Contact Lens Services Information Check-In
- Fill Out the Dry Eye Questionnaire Here
- Notice of Privacy Practices
- Consent to Treat Minor Child
- Eyeglass Prescription Policy