At VISION HAUS, 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 Microsoft Word or other word processor to view the documents.
- 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 Health History Form – Required
Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.
Guardian Permission for child under 14 - Required if guardian will not be accompanying the child to his/her appointment.
Please complete and sign this form if you are unable to come with your child to their appointment. Children 14 and older can sign for themselves.
Authorization Request - Not required
This form is used if you would like us to get your records, or prescription information from another eye doctor. Please print, fill out and bring to our office at anytime. We will then fax it to your previous eye doctor and they will fax over your records (this whole process usually takes a day or so, but can take up to a week depending on your old eye doctor.)