Patient Forms

The following forms are available for you to print at home and bring to the office. By filling out these forms ahead of time you can save time during your visit. Please be prepared to provide this information to our office along with your current insurance information. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

New Patient Forms

• LIOC New Patient Packet
• LIOC New Patient Registration Form
• LIOC HIPAA Notice Form
• LIOC Financial Policy Form
• Refraction Permissions Form
• Medical History Questionnaire 

Emergency Patient Form

• LIOC Emergency Patient Form
• LIOC HIPAA Notice
• LIOC Patient Consent
• LIOC Financial Policy Form

Existing Patient Forms

• LIOC Existing Patient form