Forms

Online Forms

Please click on the links below. PDF files will download for you to print and fill out completely. Please bring them with you when you come to our office. If you’re a returning patient please bring the HIPPA Policy Statement and your updated Medical History to our office.

New Patient Online Form – Submit Online

Simon Eye Associates Privacy Practices – Download & Print

Simon Eye Associates Privacy Practices Acknowledgement – Download & Print

Medical History – Download & Print

New Patient Data Form – Download & Print

Blood Pressure and Eye Health

23 April 2020

Your blood pressure and your eyes are connected in many ways. Did you know that high blood pressure may lead to vision loss, blurry vision ... read more

Spring Eye Allergies

11 March 2020

Ah, spring. There’s nothing like it, especially after coming off a long, cold winter. But the one thing many people dislike about spring is ... read more

How Vision Changes With Age

4 March 2020

Just like everything else with our bodies, our eyes start changing with age, usually for the worse. Particularly as we head into our 60s and ... read more

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Forms

Online Forms