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Patient Forms

Prepare in advance for your eye exam appointment at our Rockledge & Merrit Island, Florida eye clinics

Please complete the forms below and bring them with you to your eye exam.

Welcome – Patient Information Form:

Contact Lens Services Information Check In

About Your Insurance

Fill Out the Dry Eye Questionnaire Here

Notice of Privacy Practices


If you have any problem with a form, our eye doctor or staff can explain what to do during your next eye exam, or feel free to contact our office with your questions.


Yes, we are open and will support your eye care needs in every way possible.

Merritt Island: 321-454-3002 | Mon & Wed 8:15 a.m. – 5 p.m

Rockledge: 321-636-7200 | Tues & Thur 8:15 a.m. – 5 p.m.

Email –