Patient Registration Form: Please print out; bring this form with you on the day of your appointment, or scan and fax the form in.

Thank You

Patient Registration Form for Adult

Patient Registration Form for Child

Convergence Insufficiency Symptom Survey: Please print out, fill out online, or email answers to the 15 questions to our office, and this will aid in your evaluation.

Convergence-Insufficiency-Symptom-Survey