Notice of Privacy Practices Disclosure

Welcome

We would like to personally welcome you to the Eye Specialists of Ohio.

Our goal is to provide you with the highest quality eye care in Ohio. Please let us know how we can improve our practice.

Your initial visit will take approximately 1-2 hours, depending the procedures involved. As a new patient, your eyes will most likely be dilated on that day. The effects of dilation will last up to a few hours, so it is best that you plan not to drive immediately after the visit. Sunglasses will be provided, if needed for your comfort.

To assist you better with determining your needs we have included the form you would generally fill out on your initial visit. By accessing them now, you have the ability to complete this information in the convenience of your home and bringing it with you on your appointment.

Although there is just one form below, it is available in three different formats depending on which program you generally use on your PC.

Please click one of the links below to download the new patient information form that suits you best.

You must have Microsoft Word to View this form

You will need the free version of Adobe Acrobat installed on your computer to print and view this form. You can download it HERE!)

Print Form from a Printer friendly Screen.