Patient Forms

You may submit your information through our online patient forms or printable patient forms and bring them to your appointment.

We require intake forms to be completed before your appointment is scheduled to begin. Your scheduled exam time does not include time for forms to be completed, so please arrive early to complete them if necessary. Thank you!

Online Patient Forms

Click here to complete your intake forms online. You need to complete three tabs and the Submit Data tab:

  1. Demographics tab
  2. Age-appropriate intake tab
  3. One of the services tabs – Neuro, Vision Therapy or Low Vision

The LAST STEP is to click on the Submit Data tab and click the SUBMIT DATA button.

You cannot save your information and return at a later time, so please allow at least 15 minutes to complete and submit your information in one session.

Printable Patient Forms

Please select two of the PDF forms below and bring them completed to your appointment.

1 – Child History Intake or Adult History Intake

2 – Vision Therapy Intake, Neuro-Optometry Intake, or Low Vision Rehab Intake

Returning Patients

If you have been seen in our office before, please call us at (913) 469-8686 and we’ll give you a passcode to update your information online.

Patient Portal (For current patients only)