When you contact our offices to schedule an appointment, please ask one of our staff which form(s) you will need to complete prior to your visit. All patient forms are provided below in Adobe Acrobat format, in addition to a link to the Adobe Acrobat download web site.

To complete the form(s) on your computer, click the appropriate form(s) link below, fill in the blank fields with your personal data and then save the completed form(s). Please then attach the completed form(s) to an email and send the email to: empireeye@empireeye.com

If you are unable to complete the necessary forms via computer, they will be provided to you at our offices when you arrive for your appointment.

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Empire Eye Physicians Patient Forms

	Empire Eye Physicians Patient Registration Form
	Patient Medical History Form
	Refraction Policy Form
	Quality of Vision Form

Empire Eye Surgery Center Patient Forms

	Advanced Directive Form
	Patient Medication Overview Form
	Patient Medication List Form
	Patient Rights Form
	Patient Surgery Sign-Off Form

The Laser Institute at Empire Eye Physicians Patient Forms

Patient Registration Form