We value your time! In an effort to save you time in our office, you can download and complete our patient form prior to your appointment.
- You will need AdobeReader® to download and complete the form.
- Download the required form. Print out the form and complete the required information.
- Bring the completed form with you to your appointment and please arrive a few minutes earlier than your scheduled appointment time to allow our staff to process your information.
New Patient Form
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
Print & Complete Form – Established Patient Form
Print & Complete Form – New Patient Form
Print & Complete Form – COVID-19 Consent rom
Massapequa Optometric Care
Massapequa, NY 11758
Mon: 10:00AM - 7:00PM
Tues: 10:00AM - 5:00PM
Wed: 10:00AM - 6:00PM
Thur: 10:00AM - 7:00PM
Fri: 10:00AM - 5:00PM
Saturday: 9:00AM - 2:00PM