In preparation for your eye and vision examination, we invite you fill out the necessary paperwork prior to your arrival by clicking on the appropriate links below.   This information is an extremely important part of your visit, which allows the Dr. Wilmes and our staff to provide you with highest level of care and service, both in the exam room and with the submission of any insurance claims.

We know that these documents can be time consuming, but we sincerely appreciate your willingness to fill them out as thoroughly and accurately as possible.

When making your appointment, you will be instructed as to which forms are pertinent to your visit.  Please note, these PDF documents are formatted to allow you to enter the requested data directly into each field.  Once all necessary forms are completed, please print each document and bring with you to your exam.

 

FORM 1 – Patient Authorization  (Please click here to read about the optional tests we offer)

FORM 2 – Patient Demographic Insurance

FORM 3 – Patient Medical History

 

Should you have any questions, please feel free to contact us during normal office hours.  Thank you in advance for your cooperation!