Patient Forms Eye Care Arkansas - Ophthalmology And Optometry In Little Rock, AR USA :: Online Forms

Online Forms

Patient Portal

If you are a new patient or you have not been seen at our clinic in 3 or more years, please print and complete the following forms:

Registration Form

Medical History Form

HIPPA & Privacy Policy

Demographic Information

Financial Policy

If you have an appointment for a cataract evaluation please complete the dry eye questionnaire and the applicable cataract lifestyle questionnaire.

Dry Eye Questionnaire

Cataract Lifestyle Questionnaire - 1st Eye

Cataract Lifestyle Questionnaire - 2nd Eye

If you would like to request your medical records be sent to or from our office, please print and complete the following form:

Release of Medical Records - Outgoing

Release Of Medical Records - Incoming

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Hours of Operation

Eye Care Arkansas


8:00 am-5:00 pm


8:00 am-5:00 pm


8:00 am-5:00 pm


8:00 am-5:00 pm


8:00 am-5:00 pm






Reviews From Our Satisfied Patients

  • "We use Anderson Optometry for all of our family’s vision needs. Recently, we had to have our youngest fitted for new glasses and he made the experience fun for her and informative for us. We know Dr. Anderson will always take good care of our family’s eye care and that’s why we wouldn’t go to anywhere else."
    The Harrison Family
  • "Dr. Anderson and his staff are so patient and friendly. Dr. Anderson prescribed me glasses and I had the toughest time picking out frames. They didn’t rush, but instead made helpful suggestions and now I have an awesome pair of frames, not to mention the fact that I can see ten times better than before. You guys are the best!"