MEDICAL QUESTIONNAIRE

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We would like to thank the person who referred you to our office: How did you hear about us? (friend, co-worker, family, google, insurance, etc.
So we may better serve your vision needs, please complete the questions below regarding your visit to our office:
(For Diabetics Only)
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Dilation informed consent: Dilation is recommended every other year, even in healthy eyes. First visit to our office. Dilation may be required more frequently by your eye doctor for many ocular and systemic conditions. Many serious and sometimes vision threatening conditions cannot accurately diagnosed or detected without dilation. Dilation will make you light sensitive, and will make your distance and near vision blurry (mostly near). Driving is usually safe when dilated, and the patient assumes all risks of operating a motor vehicle, as well as any other visually demanding tasks, while dilated.