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Online Forms

At Envision Eyecare, 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 AdobeReaderĀ® to download and complete the forms.
  • 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

Patient Health History Form

Download & Print Form


Privacy Policy

Download & Print Form


Financial Agreement

Download & Print Form


EyeScreen Photographic Examination

Download & Print Form


Warranty Brochure

Download & Print Page 1

Download & Print Page 2


Download the Free AdobeReaderĀ®

Lees Summit Office

Monday:

8:00 am-5:30 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

8:00 am-5:30 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-1:00 pm

Saturday:

9:00 am-1:00 pm

alternating Saturdays

Sunday:

Closed