Patient Resources
Forms
Please complete the appropriate form before your visit to help us prepare for your appointment and provide the best possible care. The forms are simple, save time during check-in, and ensure we have the information we need to take great care of you.
Please download, fill out, and bring the completed forms with you to your scheduled visit.
Before Your Visit
Choose the form that applies to you
New Patient Forms
For patients visiting our office for the first time. Download, print, and complete the registration, financial policy, privacy practices, and medical history forms before your visit.
Download, fill out, and bring it with you to your scheduled visit. New patients must arrive at the clinic 15 minutes before their scheduled appointment. Please also call your previous eye doctor and request that your records be faxed to (703) 345-9356 before your visit.
Download & Print FormInsurance & Registration Form
Download, print, and complete your insurance details, pharmacy, primary care provider, and emergency contact information before your visit.
Download, fill out, and bring it with you to your scheduled visit.
Download & Print FormCataract Questionnaire
For patients scheduled for a cataract evaluation or surgery consultation. Helps us understand your visual symptoms, lifestyle needs, and lens preferences.
Download, fill out, and bring it with you to your scheduled visit.
Complete Cataract QuestionnaireReferral Form
For referring providers or offices submitting a patient referral. Download, print, and fax the completed form.
Download, fill out, and fax the completed form to (703) 345-9356.
Download & Print FormNeed help with a form?
If you are unsure which form to complete or have trouble accessing a form, our team is happy to assist. Call us during office hours and we will guide you through the process.