Patient Forms and Resources
Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please download, print, and complete the forms and bring them with you to your appointment. If you are unable to download our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.
Notice of Privacy Policies
This notice describes how medical information about you may be used and shared and how you can get access to this information please review it carefully.
Welcome to West County Ophthalmology. Here are some things to help you first visit with us go smoothly as possible.
Record Release Form
Authorization for release of individually identified health information.
Misplaced your Amsler Grisd? You can print a new one!
Notice of Non-Discrimination
Discrimination is Against the Law
*Individual results are not guaranteed and may vary from person to person. Images may contain models.