Patient Forms - Volunteer Eyecare
Volunteer Eyecare

It’s new and it’s free! We now offer a smart phone app for both iPhone and Android users. Access your account or schedule an appointment from the palm of your hand.

Patient Forms

At Volunteer Eyecare, we value your time.

Please take a moment to fill out the new patient forms in the following link. Don’t forget to bring your driver’s license and insurance card(s) to your first appointment. Our forms are HIPAA compliant; your information is protected.

If you are an existing patient and have had any changes to your contact or insurance information, please make sure to let us know at your next appointment so we can get a new copy of your driver’s license and/or insurance card(s). It would also be helpful if you could bring the following physical items with you as well:

  • Current eyeglasses
  • Copies of prior spectacle or contact lens prescriptions (even if expired)
  • Any prescription or over-the-counter (OTC) Eye Drops you have used or are currently using
  • Empty Contact Lens Boxes (we love to know what brand you currently wear and the prescription is on the box)

If you prefer not to fill our forms online, please print, fill, and bring the following forms with you to your next appointment.