Online Forms

At Optimum Eyecare, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Download the Free AdobeReader®
  • Download/print the required forms and complete the required information.
  • Email your completed forms to "[email protected]" or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form. 

***VERY IMPORTANT*** There are times when we have to call on trusted family and friends to bring our minor-aged loved ones to their eye exams.  The legal parent/guardian MUST also provide a valid copy of a government identification document (driver's license, passport, etc.) in addition to being the person to SIGN the attached forms.

Download & Print Form

If you have any questions, please do not hesitate to contact our office by calling (817) 419-8871.

Appointment Request


Please do not submit any Protected Health Information (PHI).


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