Here are our forms that we require each new patient and every previous patient to fill out annually due to insurance and patient information changes. Please print off the forms below, fill them out and bring them with you to your examination.

Patient Information and Insurance Form

Medical History Form

Your Visual Lifestyle Questionnaire

Our Financial Policies

Our HIPAA Policy Statement


If you have any problems printing these forms, please call our office at 765-348-2020 and we can send them or email them to you.