Online Forms

At Evergreen Vision Clinic P.C., 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.

  • You will need AdobeReader® to download and complete the forms.
  • 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 – Required

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 you have regarding your eye health or vision on the form.

Download & Print Form

Evergreen Records Release (from EVC)

Download & Print Form

Evergreen Records Release (to EVC)

Download & Print Form

Patient Authorizing EVC (PHI to Family)

Download & Print Form

HIPAA Notice of Privacy Practices

Download & Print Form

Evergreen Vision Warranty

Download & Print Form


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Contact Us

We look forward to hearing from you.

Location

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Hours of Operation

*Every Thursday the clinic & optical boutique are closed from 10:30am - 1:30pm for staff development

Clinic Hours

Monday:

8:00 am-5:30 pm

Tuesday:

10:00 am-5:00 pm

Wednesday:

7:30 am-5:30 pm

Thursday:

8:00 am-6:30 pm

Friday:

7:30 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Optical Boutique Hours

Monday:

8:00 am-5:00 pm

Tuesday:

10:00 am-4:30 pm

Wednesday:

7:30 am-5:00 pm

Thursday:

8:00 am-6:00 pm

Friday:

7:30 am-4:30 pm

Saturday:

Closed

Sunday:

Closed