Patient Forms

New Patient Forms

If you are new to our practice, we encourage you to download and print out the new patient forms. Completing them in advance will minimize the time necessary to check-in at our front desk.

Consent for Treatment of Minors

Columbus Ophthalmology Associates strongly encourages that a parent or legal guardian accompany any minor child (17 years or younger) to their medical appointments. In the event that a parent or legal guardian is unable to accompany his or her minor child to a medical appointment, the parent or legal guardian should download this form and either (1) sign this Consent for Non-Emergency Treatment of Minors and mail or fax to our office prior to the medical appointment or (2) sign this form and give it to the minor child to present at the time of the medical appointment. In the event that a minor child presents for a non-urgent medical appointment without a parent or legal guardian or a signed consent, treatment will be denied.

Consent For Treatment of Minors

Annual Contact Lens Agreement

At Columbus Ophthalmology Associates, we carry the latest in contact lens technology and specialize in the difficult-to-fit patient. A Contact Lens Fit Evaluation or Re-fit Evaluation is necessary every year to determine the contact lens prescription and is in addition to the comprehensive eye examination fee. This evaluation will include precise measurements, analysis of your vision needs and recommendations specifically tailored for you. Please print, sign and bring this form with you to your next contact lens evaluation appointment.

Contact Lens Agreement

Contact Lens Questionnaire

At Columbus Ophthalmology Associates, our optometrists want to understand your contact lens needs to evaluate the best contacts for you. Click the link below to fill out our contact lens questionnaire prior to your appointment.

Contact Lens Questionnaire

Medical Records Release

You can print and complete this Medical Records Release Form and submit it by Fax or mail to the address listed on the form. By law, turnaround time for medical form release requests must be within 30 days. We will make every effort to achieve a turnaround time of 7 – 10 days.

Medical Records Release