At The Eye Center of Conyers, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Patient Health History Form – Required for all patients

In order to save you time during your visit…

Please complete these two forms as it lets us know the history and current state of your health and provides you with information that you must accept in regards to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Health History Form – Download & Print Form
Patient HIPPA Consent form – Download & Print Form

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