Patient Forms

Need to fill out a form?

Thank you for choosing McMillin eyecare for your eye health and vision care needs. To help us establish your records and provide the most beneficial use of your time with us, our doctors have requested that you review and complete the following tasks and bring the information to your appointment. This will help our doctors give you the best care possible.

Patient Information Form

Build your account with McMillin eyecare through completing our Patient Information Form. This is the first step for all of our patients. This information includes personal and family information needed to establish or update your file.

Patient Medical/Vision History Form

Once you complete a Patient Information Form please fill out a Medical/Vision form. Since many general health conditions may be associated with visual symptoms and/or eye health problems, this important record (now required by state health boards and virtually any medical and optical insurance plans) will allow us to care for you as a “whole person” rather than just a pair of eyes. This form includes a complete list of prescription and nonprescriotion medication, which may be brought in as a separate list for us to photocopy if you prefer. Your responses will help guide our doctors and staff, and remind us to address any significant issues during your visit.

Download & Print Forms

Treatment Forms

Full Face Treatment

If you are getting a full face treatment, please print and fill out ALL forms listed, and bring them with you to your appointment.

Dry Eyes Treatment

If you are exclusively getting treatment for dry eyes, please print and fill out ALL forms listed, and bring them with you to your appointment.

Pre-Visit Information:

Eyeglasses

Please bring ALL pairs of eyeglasses you currently use, including prescription or nonprescription reading glasses, sunglasses, etc. We have instruments to compare the optical power of your old lenses with your new exam findings, thus enabling us to determine and explain how your vision has changed over time. We can also evaluate the condition and fit of your current eyewear.

Contact Lenses

It is best to wear your current contacts to your appointment if possible. If you can not wear your lenses, please bring them in your case. If you wear planned replacements or disposable lenses, it is helpful if you bring along your cartons or lens packets that indicate the lens series, power, manufacture, etc.

Eye Drops, Ointments, etc.

Please place any eye drops or ointments that you use in a small bag and bring it along with you. Your doctor will review whether these are appropriate or if a better option is available.

Dilation

The doctor may need to use drops to dilate your eyes in order to fully evaluate their internal health. This has the effect of temporarily increasing sensitivity to light and causing “fuzzy’ vision at a near (reading) distance. Therefore, if you feel you may need eyewear or want to select new eyewear, please come 15-20 minutes before your appointment time in order to look at our frame selection.

Completing the task list for the items that apply to you will assure you of receiving the most thorough and professional care possible and in a very efficient manner.

We look forward to your visit!