• Vision Like You’ve Never Seen Before

Patient Forms

For your convenience, we have made a number of forms available for patients to download. If you are new to our practice, we encourage you to download and print out the new patient forms. Completing and returning these prior to your first visit will minimize the time you spend in the waiting room filling them out when you get here. Other forms are informational. If your doctor has given you a form with specific information or instructions different from the information on these online forms, rely on the information given to you by your doctor, not on the online forms. If you’re not sure which forms you need, please call 314.921.2020 for assistance.

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Completed Forms

The completed forms can be returned to us by several methods.  Since some of the forms do contain confidential information, please return them by whichever method you can send securely and safely.

  • e-mail to medicalrecords@surevision.us
  • fax to 314.838.9536
  • mail or bring to SureVision Eye Centers, 7934 North Lindbergh Blvd., Hazelwood, MO 63042


Click on the forms you would like to download: