Need to update your patient information? Update Existing Information Prefer to print out the form and bring it in? Click here to download the PDF. Preferred Name* Email Address* Family Doctor First Last Change in MedicationsUpload Medication FileAccepted file types: jpg, gif, png, pdf, pages, excel, keynote, Max. file size: 128 MB.What is the primary reason for your visit? Do you wear contact lenses? Yes No I used to wear contacts, but stopped I am interested in trying them Do you currently use any eye drops? Yes No Which ones Do you have any symptoms of dry eyes? These include grittiness, stinging, burning, redness and excessive watering with prolonged screen time. Yes No PhoneThis field is for validation purposes and should be left unchanged.
