Exam Forms

1. Find the right form(s) for you
   
2. Click on "Download Form"
   
3. Open the .pdf file on your computer with Acrobat Reader
   
4. Fill out the electronic form to the best of your knowledge and we'll help with the rest
   
5. Print out the form (or Save and print later)
   
6. Bring the forms in with you for your visit

Will you want a prescription for contacts? Download Form


Will you be using Tricare, Medicare, or other insurances?

Tricare - Download Form

Medicare- Download Form

Other Insurance - Download Form

Not Using Insurance?

 If you are not using insurance you can have a comprehensive eye exam or an intermediate examination.

A comprehensive exam will take about 45 minutes. It includes an comprehensive evaluation of your history, evaluation for glasses, automated screening visual field analysis, auto-refraction, glaucoma pressure test, stereo test, color vision test, strabismus evaluation (binocular vision testing), version testing, pupil evaluation, a thorough evaluation of the anterior and posterior segments of the eyes using dilating drops, administering a binocular indirect ophthalmoscopic evaluation for disease, and a comprehensive digital evaluation of the inside of your eyes with a non-mydriatic fundus camera.

Comprehensive Exam - Download Form

An intermediate exam will take about 15 minutes. It includes a brief review of your history, evaluation for glasses, auto-refraction, pupil evaluation, brief visual field analysis, glaucoma pressure test, and a limited evaluation of the eye for disease without dilation.  We do not recommend this type of evaluation if you have not had a comprehensive exam recently, or have a disease that can cause problems with the eyes.

Intermediate Exam - Download Form