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Patient Forms

To continue to provide you with the best in eye care services we have moved to a new computer system.
Therefore, we are need new and established patients to please complete our new Web Registration forms prior to your appointment.
If you are not able to fill out your forms online, please arrive at least 30 minutes prior to your appointment time to complete these forms.
This link can be used for multiple family members. 


You will be guided to two forms:

1.  Patient Intake and Health History Forms
2. New Patient HIPAA and Financial Forms
(to get to HIPAA and Financial forms, please click continue after you have completed the Patient Intake and Health History Forms)

We appreciate your help as we strive to provide you with truly personalized eye care!

Follow this link to learn about the Modern Heritage Eye Care Members Only Savings Plan

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