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Online Forms

At F.Y. Eye Care Associates, 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.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


Notice of Privacy Practices

Download & Print Form


HIPPA Release Form

Please complete this form if you would like anyone besides yourself (or parent/legal guardian for patients under 18 years of age) to have access to your protected health information.

Download & Print Form


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Sign Up Using the Form Below or Call (704) 875-8787 to Make an Appointment.

OFFICE HOURS

Our Regular Schedule

Monday:

8:40AM - 1PM

2PM - 5PM

Tuesday:

9:45AM - 1PM

2PM - 6:30PM

Wednesday:

8:40AM - 1PM

2PM - 5PM

Thursday:

8:40AM - 1PM

2PM - 5PM

Friday:

8:30AM - 1PM

Closed

Saturday:

By appt only

Sunday:

Closed

Closed

Locations

Find us on the map