Online Forms

At Wallace Optometry Associates, 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 AdobeReaderĀ® to download and complete the forms.
  • 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.

New Patient Forms

Please complete the following form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form.

New Patient Info Form | Fill Online form

Medical History Form | Fill Online form

Information Release Form | Fill Online form

HIPAA Notice of Privacy Practices


Download the Free AdobeReaderĀ®

Hours of Operation

Monday

8:30 am - 5:00 pm

Tuesday

8:30 am - 5:00 pm

Wednesday

8:30 am - 5:00 pm

Thursday

8:30 am - 5:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Monday
8:30 am - 5:00 pm
Tuesday
8:30 am - 5:00 pm
Wednesday
8:30 am - 5:00 pm
Thursday
8:30 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Location