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Patient Forms

Please print out these forms, fill them out completely at your leisure, and bring them in to your exam.  This will limit your time in our reception area.  

 

New Patients


Click Here!Click Here for online-fillable forms!

Click Here for printable forms!

 

Existing Patients (forms for those of you who have visited us before)

    

For Patient Info Only--Do Not Need to Complete

Click Here!
Click Here!

 
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Free Movie!

Free Movie Tickets 

Here at Premier Eyecare, we value all of the word-of-mouth referrals we receive.  To show our appreciation, we are offering a pair of movie tickets to each patient who refers a new patient to our office. 

Ask us for details!