Online FormsOnline Patient History

It is always our goal at VisualEyes of the Palm Beaches to give you the eye care you deserve in a timely manner.

In order to ensure that your first visit goes smoothly, you may want to complete the forms below prior to your visit. You can even fax us your forms or drop them off prior to your appointment to speed up your first visit.

New Patient Form: Download & Print Form

About Your Insurance: Download & Print Form

Notice of Privacy Policy Form: Download & Print Form

Adult Case History Form: Download & Print Form

Children’s Extended Case History Form: Download & Print Form

Authorization to Accompany a Minor Child: Download & Print Form

You will need Adobe Reader® installed on your computer. If you don’t have it, click here to download it. Click Here to download.

If you have any questions about our office or our forms, don’t hesitate to contact us today at (561) 625-4380.