Patient Forms


Please note:  We kindly ask all patients to fill out the online forms before their appointment. We are no longer allowing patients to fill out paperwork in our office due to COVID-19 in order to increase safety. This will speed up the check-in and appointment process. Thank you.  

Consent to Treat - REQUIRED YEARLY FOR ALL PATIENTS

We are required to update this form yearly for all patients - both new and returning patients. This gives us permission to conduct your eye exam and allows us to share your information with authorized persons. Click to access our  Consent Form 


New Patient Forms

If you are a new patient, or have not had an exam in 3 years, please complete this Online Registration before your appointment.

Please remember your confirmation number given to you with the online registration.


Frequently Used Patient Forms

Records Release Form (needed if requesting records) Your medical records are considered Protected Health Information (PHI). So, if you need us to release your records to you or another doctor, please complete this form. Download Records Release Form

Risk Assessment Form: Age Related Macular Degeneration (AMD) (optional) This will help us determine your risk level for AMD. AMD is the leading cause of vision loss in adults, currently affecting more than 15 million Americans. Its effects may be permanent and irreversible however you can reduce your risk. Download AMD Risk Assessment Form

Eye Health Screening Photos Form (optional) This optional procedure takes High Definition Photos of your Retina (the back of your eye). These images are very helpful in determining internal eye disease and also helps to monitor changes in the future. Please see the video below and download the form if you are interested in taking advantage of this procedure at your next visit. Download Eye Health Screening Photos Form

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Location

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Hours of Operaton

Our Regular Schedule

Overland Park Office

Monday:

8:00 am-5:00 pm

Tuesday:

7:00 am-5:00 pm

Wednesday:

8:45 am-6:00 pm

Thursday:

8:45 am-5:00 pm

Friday:

7:00 am-3:00 pm

Saturday:

Closed

Sunday:

Closed

Gardner Office

Monday:

8:30 am-5:00 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-5:00 pm

Friday:

Closed

Saturday:

Feb 6, Mar 6, April 3

Sunday:

Closed