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At Harris Eye Clinic, 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.

New Patient Health History Form – Required

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

*Please fill in everything above the triple black lines on the second page*

Download & Print Form


Download the Free AdobeReader®

Exclusive Offer

THIS ---->https://harriseyeclinic.imatrixbase.com/online-forms.html

Office Hours

DayOpenClosed
Monday8:15am5:00pm
Tuesday8:15am5:00pm
Wednesday8:15am5:00pm
Thursday8:15am5:00pm
Friday8:15am5:00pm
SaturdayClosedClosed
SundayClosedClosed
Day Open Closed
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:15am 8:15am 8:15am 8:15am 8:15am Closed Closed
5:00pm 5:00pm 5:00pm 5:00pm 5:00pm Closed Closed

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