Online Forms
This lets us know the history and current state of your health. Filling out these online forms beforehand will save valuable time for our patients, staff and doctors on the day of the appointment. What questions, concerns, goals, regarding your vision can we help you with? Let us know!
New Patient Health History Form - (Required for New Patients Only) - Download & Print
Notice of Privacy Practices - (Required for New Patients Only) - Download & Print
Authorized Disclosure of Private Healthcare Information - (Required for New Patients Only) - Download & Print
Note: This form went into effect in August 2016 and conforms to the guidelines recommended for proper insurance billing and reimbursement. Even if you are a long time patient, we greatly appreciate your assistance in updating this information so your visit can be billed properly.
Thank you!
Dr. Jeff Sarazen was named the Wisconsin Optometric Association's 2015 Optometrist of the Year! 