Patient Forms

Please print the below forms, fill them out and bring them with you to your visit to Doctors Eyecare Centers of SW Florida, LLC in Fort Myers.

You should be aware that we will need a little extra time to get all of this information entered if you bring the forms into the office. Therefore, we need you to come 20 minutes earlier than your appointment time.

Please bring your insurance cards, identification, a list of your current medications, and your all of current eyewear.

For your convenience, we have created a different page to provide you with a list of the insurance carriers we accept at our Fort Myers optometric office.

• Welcome to our office
• Patient History 
• Lifetime Consent For Release of Health Information
• Notice of Privacy Practices
• Dry Eye Questionnaire (Adults Only)
• AMD Questionnaire (50 and over)
• Medication List