Online Forms

Anderson Eyecare offers our patient forms online so they can be completed in the convenience of your own home or office. As a patient at Anderson Eyecare, you have two choices in completing your paperwork. One choice is to complete your forms online and submit them to us via our secured website. Your second choice is to print out the forms and bring the completed forms with you to your appointment.

If you are new to our practice

Please submit the form online, OR download and print the PDF below.

Online Forms

New Patient Information Form (Required) - Submit Online

Acknowledgement of Privacy Policies and Practices (Required) - Submit Online

Download & Print Form

New Patient Information Form (Required) - Download & Print

Optomap/Dilation & Enhanced Testing Form (Required) - Download & Print

Acknowledgement of Privacy Policies and Practices (Required) - Download & Print

If you are returning to our practice

Please submit the form online, OR download and print the PDF below.

Online Forms

Established Patient Information Form (Required) - Submit Online

Download & Print Form

Returning Patient Information Form (Required) - Download & Print

Optomap/Dilation & Enhanced Testing Form (Required) - Download & Print

All Individual Patient Forms

Established Patient Information Form (Online)
New Patient Information Form (Online)

New Patient Information & Medical History (Printable)
Returning Patient Welcome Form (Printable)
Contact Lens Services (Printable)
Optomap/Dilation & Enhanced Testing Form (Printable)
HIPAA Privacy Policy
Acknowledgement of Privacy Policies and Practices