If you are transferring your care to Eola Eyes and would like us to obtain your records from your previous eye care provider, please complete this form to authorize the release of your previous prescription and eye health records.
New patients or patients who have not been to our office in three or more years, please click the box below to provide your current demographic, health, and insurance information and to review our office policies.
These electronic forms will securely transmit your information directly to our office. Thank you for taking the time to complete them prior to your visit!