We are reopening on June 2 with full precautions. Please call the office to arrange appointments.

More Info About Our In-Office Safety Protocols

Patient Registration

Welcome! Please help us serve you by filling out this form and submitting it to our office. We look forward to assisting you!
  • About You

  • Date Format: DD slash MM slash YYYY
    DD/MM/YYYY
  • Format 10 digits and 2 letters (####-###-###-AA)
  • Date Format: DD slash MM slash YYYY
    DD/MM/YYYY
  • Ocular History

  • Date Format: DD slash MM slash YYYY
    DD/MM/YYYY
  • Medical History

  • Please include hormones, Birth control, and non-prescription medications
  • Please include food, seasonal, and medical