At Brecheen Learning and Vision Center, 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. Click here to download.
- 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.
Adult New Patient Form
Child New Patient Form
Lifestyle Checklist for Extended Non-Routine Visual Evaluations
Please fill out this form only if not coming in for a regular eye exam, but for an Eye Trac or an Orthoptics evaluation.