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Online Forms

We value your time. In an effort to save you time, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Packet: Download and Print

This form lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.


Vision and Learning Evaluation Packet: Download and Print

This form lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.


Traumatic Brain Injury Exam Packet: Download and Print

This form lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.


HIPAA Privacy Policy Form:

Download and Print


Financial Agreements Form:

Download and Print


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Location

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Hours of Operaton

Our Regular Schedule

Wexford Office Hours

Monday:

10:00 am-7:30 pm

Tuesday:

10:00 am-7:30 pm

Wednesday:

10:00 am-7:30 pm

Thursday:

8:00 am-4:30 pm

Friday:

8:00 am-4:30 pm

Saturday:

8:00 am-2:00 pm

Sunday:

Closed

Wexford Vision Therapy Hours

Monday:

10:30 am-7:00 pm

Tuesday:

9:30 am-7:00 pm

Wednesday:

8:00 am-7:00 pm

Thursday:

8:00 am-7:00 pm

Friday:

8:00 am-4:30 pm

Saturday:

8:00 am-1:00 pm

Sunday:

Closed

Fox Chapel Office Hours - Vision Therapy Only

Monday:

Closed

Tuesday:

9:30 am-7:00 pm

Wednesday:

Closed

Thursday:

8:30 am-7:00 pm

Friday:

Closed

Saturday:

8:00 am-1:00 pm

Sunday:

Closed