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Online Forms

At Independence Family Eye Care, 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 below to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Bring your printed and completed form(s) with you to your office or fax them to the office before your appointment

New Patient Welcome Form – Required

Please complete this form and bring it to the office 20 minutes before your appointment time. Let us know what questions, concerns, you have at the check in.

Download & Print Form

Retinal Imaging Form

Download & Print Form


HIPAA Form

You can print or read you HIPAA rights as a patient.

Download & Print Form



Download the Free AdobeReader®

Don't Forget to Use Your Flex Spending Money by December 31! It Can Be Used Toward Glasses, Contact Lenses and Eye Exams. We Now Accept Care Credit.

Hours of Operation

Our Regular Schedule

Monday:

9:00 am-5:00 pm

Tuesday:

10:00 am-6:30 pm

Wednesday:

9:00 am-4:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Location

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