Let us get to know you

Online Form

At St Luke Eye Institute, 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.

Follow the instructions below to complete your new patient form.

You will need AdobeReader® to download and complete the forms. Click here to download.

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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

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.

Download & Print Form

Download the Free AdobeReader®

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Opening Hours

Mo   8:30 am - 5pm

Tue   8:30 am - 5pm

Wed   8:30 am - 5pm

Thu   8:30 am - 5pm

Fri   8:30 am - 5pm

Sat   Closed

Sun   Closed