Restore Eye Care & Eye Gym Online Forms

At Restore Eye Care & Eye Gym, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
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  • If you do not already have AdobeReader® installed on your computer, Click Here to download it now.

  • Download the necessary form(s) and fill in the required information.

  • Fax or email us your completed form(s) or bring them with you to your appointment.

Electronic Media Consent Form
Download
Release of Information
Download
Privacy Notice
Download
Signature on File
Download
Lifestyle Checklist Form
Download
Post Vision Therapy Questionnaire
Download