Patient Center

Welcome to the Patient Center for SouthWest Eyecare! We understand that your time is precious and that you need an optometrist who is professional, yet convenient for your lifestyle. In order to make the transition to our office smoother for you, we have created a Patient Center with everything you need to get started.

In an effort to make you more comfortable when you arrive at our office and to streamline the new patient process, you will be able to complete all the necessary items prior to your first visit. At SouthWest Eyecare, we strive to make sure the time we spend with you during your visit is quality time.

Thank you for choosing us. We look forward to seeing you soon.

PATIENT HEALTH HISTORY / INSURANCE FORM – REQUIRED 

 NEW PATIENTS - Please click on the link below and then select the New Patient Page. Please fill out all sections that apply to your situation and hit the SUBMIT button at the end of the page.

 RETURNING PATIENTS - Click on the link below and then enter the password _(PROVIDED BY OUR STAFF: 614-801-2020)_ to access the secure form. The information we have on file will be put into the form. Please make changes as appropriate and fill out the remaining section and hit the submit button at the end of the page. 

 Secure Online Form

New Patient Contact Parameter Form - Recommended

Please complete this form so our doctors know what type of contact you are currently wearing or bring in your contact boxes with you to your appointment,

New Patient Contact Parameter Form

Authorization for Release of Eye care Information

Please complete this form and fax or deliver to your former eye care provider so we may obtain your previous records.  Your former eye care provider can fax directly to SouthWest Eyecare with this release completed.

Download & Print Form

Download the Free AdobeReader®

Notice of Privacy Practices