Patient Forms

In an effort to maintain a safe and healthy environment, Lakeside Eye Associates is a touch-less office and we require all paperwork to be completed prior to your visit. We value the safety of you and your family as well as our staff and are taking all necessary precautions.

At this time, all patients MUST wear a mask during their visit. No other family members are allowed with you during your visit unless it is medically necessary. All minor patient appointments will be limited to one accompanying parent only.

    Please download the following required PDF forms.
    Save your completed forms to your computer.
    Attach completed forms and email to moc.seyeedisekal%40ksedtnorf or fax to 704-896-5514 before you arrive for your appointment.

Patient Information Sheet (This Is Required For New And Existing Patients)

Contact Fitting Agreement (This Is Required For Any New Or Existing Contact Lens Wearers)

Optional forms and request:

HIPAA Privacy Agreement

Medical Records Release Form