Medical Forms

Welcome to Eye Health Physicians of Lancaster!

Thank you for choosing our doctors for your eye care needs. In order to better serve you, please print out (click on the printer icon) and complete all four (4) patient information forms and bring them with you to your scheduled appointment. If you have any difficulty completing these forms, please come to the office 15 minutes before your scheduled appointment time and our staff will be happy to assist you.

  • Please bring a list of medications (including dose and frequency) you are currently taking.
  • If you have insurance coverage, we ask that you bring your insurance cards with you.
  • For those patients who belong to a managed care health program, please contact your family doctor for a referral in advance of your visit.

We hope the completion of these forms and the information requested will contribute to our efficiency and promptness when you arrive for your initial office visit.

Sincerely,

The Staff at Eye Health Physicians of Lancaster

Patient Information

eyehealthgeneralform

HIPPA Form

eyehealthhippaform

Patient History 1

patienthistoryques

Patient History 2

eyehealthmedform