Patient Forms

Location & Hours

15661 San Carlos Blvd Unit 4
Fort Myers, FL 33908
Phone: (239) 887-3187
Fax: (239) 985-9003

Monday	9:00am — 5:00pm
Tuesday	9:00am — 3:00pm
Wednesday	9:00am — 5:00pm
Thursday	9:00am — 7:00pm
Friday	9:00am — 5:00pm
Saturday*	9:00am — 1:00pm
	*1st Sat. of month only

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For your convenience, and to save you precious minutes during your experience with us, we have provided our office forms below. Click each to download, print, and fill out. Please contact us with any questions.

Insurance Agreement Form

Patient Information & Registration Form

Latest News

Want To See Better? Live...

May 14, 2019

Living an overall healthy life is good for your eyes. Healthy vision starts with healthy eating and exercise habits. There's more to complete eye health than just carrots. Are you eating food that promotes the best vision possible? Learn what foods boost your eye well-being and help protect against diseases. Here are important nutrients to look for when selecting your foods. Beta carotene or Vitamin A (helps the retina functi...

Our Mission Statement

Our mission is to deliver the highest quality of vision care to our patients through compassionate, honest and excellent service. We pride ourselves on delivering eye care with a personal touch in an environment that is both welcoming and equipped with the most up-to-date technology. We strive to provide our patients with an experience that exceeds their expectations, so they are completely comfortable referring their family and friends.

Transitions® Light Intelligence

Crizal® No-Glare Lenses

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