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South Bend

New Carlisle

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New Patients Form

Please copy and paste the link into a new browser to access the forms.

Prior to your visit with us, please copy and paste the link, into a new browser to our patient forms for secure, online completion and registration with our office. The completion of patient forms is required if you are a NEW PATIENT, or if your last visit with us has been THREE OR MORE YEARS.

Online patient registration will save you time and allow for a more relaxed experience while at our office. After completion, we suggest you print a copy of your registration form and bring it with you on your visit.

What to Bring With You

To better serve you during your appointment, please bring with you:

      • Proof of insurance (if applicable).
      • Your current eyewear and/or contact lenses.*
      • A list of medications and vitamins/supplements you take regularly.

*Please wear your contact lenses to your appointment.

If you are unsure or uneasy driving while your eyes are dilated, please be safe and bring another driver with you to your examination.

Please allow a minimum of one hour for your visit.

We look forward to seeing you soon!