810-732-2272

New Patient Forms

If you are new to our office, we ask that you fill out these forms prior to your visit. We have made these forms easy to complete online, and at the end you will click the “Submit” button and we will receive the forms in an encrypted secure email.

Please be sure to bring the following with you to your visit:

  • All pairs of glasses you wear
  • Insurance cards
  • Photo ID
  • List of current medications
  • Eye drops you are currently using
  • Payment for services. We accept Visa, Mastercard, Discover, Care Credit, personal check and cash

During your first visit you will likely have your eyes dilated. This means your eyes will be light sensitive, so please bring a pair of sunglasses for your drive home. If you don’t have sunglasses, we will provide sun wraps for you. When your eyes are dilated you will still be able to drive, but your reading vision will be blurry for a few hours.


Step 1 of 4 – Patient Information

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  • Patient Information

  • The following information is required by the government Patient Protection and Affordable Care Act of 2010.