Online Forms

ROUSE EyeCARE CENTER offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReaderĀ® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Paperwork- Required Download & Print Form or Submit Online
This is our new patient paperwork. PleaseĀ fill this out and bring it with you to your appointment.

Medical Consent & Financial PolicyDownload & Print Form

Routine Vision BenefitDownload & Print Form