Online Forms

Eyes on Main Online Forms

At Eyes on Main, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
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1. At Eyes on Main, we offer patient forms online so you can complete them in the convenience of your own home or office. If a new patient, please go to:

Online Form

Press "New patient page", complete the form, and press submit data at the end.

2. If you are a new patient to the office, please complete the Medical Records Transfer Release Form and return it to the office.
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Download PDF

3. Please bring the following to your appointment:

• Your current glasses and contact lens information

• Form of ID

• Most recent medical insurance card

• Medicine list

​​​​​​​Office Policies

Please see the link regarding our 24-hour cancellation & “No Show” fee and retinal imaging policies.

Retinal Imaging & Cancellation/No Show