New Patient Forms
Welcome to iCare Vision Center. You have three options for completing new patient forms:
- Complete them online.
- Download forms below and bring the completed documents with you to your first appointment.
- Arrive at your first appointment 15 minutes early to complete the forms.
Existing patients who need to make a change to their forms can contact the office for a passcode to do so online.
Patient & Insurance Information Form
The first part of this form asks you to provide basic information about yourself, such as name, occupation, address and phone number. The second part of the form asks for your vision and medical insurance information.
This form asks you to provide your current eye information, family eye history, and family medical history.
Notice of Privacy Practices Form
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read carefully, and sign at the bottom.
Patient Portal
Existing patients who would like to access copies of their medical records, can visit the patient portal.
Please contact our office at 740-392-4000 to get a username and password in order to access the portal.
