2126 Merrick Mall

Merrick, NY 11566 US


For Appointments

Online Forms

We value your time! In an effort to save you time in our office, you can download and complete our patient form prior to your appointment.

  • You will need AdobeReader® to download and complete the form. 
  • Download the required form. Print out the form and complete the required information.
  • Bring the completed form with you to your appointment and please arrive a few minutes earlier than your scheduled appointment time to allow our staff to process your information.

New Patient Form

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form

Download & Complete Form - Patient Intake Document

Download & Complete Questionnaire - COVID Consent

Download the Free AdobeReader®

Notice of Privacy Practices

Download & Print Privacy Practices