Patient Forms
As a new patient, we will need you to complete a few quick forms prior to your first appointment.
Please download and print the document from the link below. Please answer all fields and bring the completed paperwork with you to your appointment.
- Patients Records Release
- Registration Consents (Updated)
- Registration Form
- Pupillary Distance Agreement
- Unaccompanied Minor Treatment Consent
Patient Access
Access Eye now offers NextMD. NextMD gives you the opportunity to view statements, request appointments, request medication refills and so much more.
To access this valuable tool, click on the link below. You will need the enrollment token that was provided to you by a member of our staff.
If you need assistance, please call 540-371-2020 and speak with a patient care specialist.
Order Contacts
Patient Access & Forms
Quality Care Survey