Thank You for Choosing
Restore Vision Centers

Below you will find our patient intake forms, please print or complete the forms given to you.

Patient Intake Forms


Patient Intake Form
HIPAA Consent
Co-management Consent Form

LASIK and PRK Instructions


Pre-surgery Instructions
Post LASIK Instructions
Post PRK Instructions

For Optometrist Use Only


Pre-operative exam form
Post-operative Exam Form
Video Questionnaire
Video Answer Sheet

Please do not hesitate to contact us with any questions or concerns, we can be reached at 877-508-2020.

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