At Herkert Family Eye Care, 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 required form(s). Print out the form(s) and complete the required information.
- Fax your printed and completed form(s) to our office or bring them with you to your appointment.
New Patient Paperwork
- Statement of Financial Responsibility/Office Policy for Eyeglasses
- Lifestyle Questionnaire
- Welcome Paperwork and Health History
- Release of Identifying Health Information
- Right to HIPAA Access