Palm Vision Center
Patient Info Forms (PDFs)

A) PATIENT INFO & MEDICAL HISTORY FORM (required)
DOWNLOAD: PALMV_FORM_PatientNew_202011_f.pdf

1. Download the required form.
2. Print out the form and complete by hand (2 pages).
3. Fax or e-mail your printed and completed form to our office or bring it with you to your appointment.
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.

B) CONTACT LENS WEARING TIPS & FORM (optional)
DOWNLOAD: PALMV_FORM_ContactLenses_202007_TIPS&FORM_f_e.pdf

1. Download the optional form.
2. You do not have to print or fill out this form, just keep it for your records.
3. You will sign this form at the office after you receive your lens wearing details.