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Merritt Island Location
228 S Courtenay Pkwy
Across from Dollar General
Call: 321-616-7077

Rockledge Location
1982 US-1 #101
On the corner of US1 and Eyster Blvd, just south of Dunkin’ Donuts
Call: 321-617-5505

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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.