Online Forms

At Dr. Howard A. Sherman, Optometrist, 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.

Please complete the following forms before your appointment. These forms let us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health and vision on the form.


New Patient

A. New Patient Health History Form Pink Download & Print Form

B. Adult's Health History Form Yellow Download & Print Form

C. Children's Medical History Form Download & Print Form

D. Dilation Consent Purple Form Download & Print Form

E. Quality of Life Vision Profile Download & Print Form

F. Release Medical Information to Dr. Sherman Download & Print Form

G. Notice Of Privacy Practices 


Returning Patient 

A. Returning Patient Health History Form Download & Print Form

B. Returning Patient Insurance Information Download & Print Form

C. Returning Dilation Consent Form Download & Print Form


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Location

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Hours of Operation

Our Regular Schedule

Monday:

Closed

Tuesday:

9:30 am - 7:30 pm

Wednesday:

Closed

Thursday:

9:30 am - 7:30 pm

Friday:

9:30 am - 1:00 pm

Saturday:

Closed

Sunday:

9:30 am - 1:00 pm

Recycle Contacts

Recycle Contacts