Office: 704-792-2777
After Hrs Emergency: 704-433-3250

Patient Forms

Click on one of the options below to either fill out your forms online and submit them, or you can download a pdf form document and print them out and bring them into the office with you.

Online Forms

(**Forms are in Submissive PDF format and may take a moment to load. Complete as much of the form as possible, as it will save you time at the office. Be sure to double check before clicking submit)

Modern Eye Care Online FormNew Patient Welcome To The Office Online PDF Form

Modern Eye Care Online FormReturning Patient Online PDF Form

Download & Print Forms(Right Click and Save Target)

Modern Eye Care Download Forms New Patient Welcome To The Office PDF Form

Modern Eye Care Download Forms Welcome Back To The Office PDF Form

**Please remember to bring all glasses (regular, computer, sunglasses, old glasses, back up glasses etc) with you to your appointment.

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Scholarship Application Form (Right Click and Save Target or Save Upon Opening)

This form is to be used for those individuals attending specific schools wishing to apply for the scholarship.

Modern Eye Care Download Forms Scholarship Application Form