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

Eye Safety Tips for Halloween

29 October 2019

With Halloween at the end of the month, you’re probably already stocking up on costumes, candy, pumpkins and spooky decorations. It’s easy ... read more

How to Tell If Your Child Needs Eyeglasses

4 October 2019

From squinting to eye rubbing, even to a drop in grades at school, vision problems in your child can manifest themselves in many ways. As a ... read more

Take These Steps to Help Preserve Your Vision

29 August 2019

From annual eye exams to wearing the right sunglasses, there are many ways you can preserve your vision. Let’s go over some helpful ... read more

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Forms

Online Forms