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At Eye Care Arkansas, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • 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.

Please print and complete the following forms if you are a new patient or returning patient who has not been seen in 3 or more years.

Registration Form

Medical History

Mission Statement/Financial Policy


What to Bring to Your Appointment

Please bring your current insurance cards, both medical insurance and vision insurance, to each visit.

If your insurance requires a referral, please call your primary care doctor's office to have this arranged prior to your appointment.

If your insurance requires a copay, you will be expected to pay this at the time of your appointment.

Bring a list of your current medication, both oral and eye drops.

Bring your current glasses and, if you wear contact lenses, your contact lens information.

Contact lens examination fees may be incurred during your appointment and are not generally covered by your insurance.  You will be expected to pay these fees at the time of your appointment.

If the patient is a minor (under the age of 18), they must be accompanied by a parent or guardian.

Your eyes may be dilated during your exam, if you are not comfortable driving after dilation, you may want to bring a driver along with you to your appointment.

Also, be sure to bring sunglasses with you.  If you forget to bring them, we provide complimentary sunglasses at our check out desk.


To learn more about what to expect during an eye exam click the link below:

Eye exam: What to expect


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