New Patient Form - Every new patient, or new to a location patient needs to fill out one of these forms in order for the doctors to have updated medical information, as well as personal information. If you would like to save time before your appointment, please feel free to download this form and fill it out ahead of time. Please bring it with you for your appointment (refrain from faxing or emailing it in ahead of time) along with a photo ID and your medical insurance card. Refer to our Office Policies, under the "Locations" link, on this site for further information.

Medical Records Release - In order for us to respect our patients' private information, we must  have all records release requests in writing, whether we are sending the records to another doctor's office or directly to the patient. If you need a copy of your records, please fill out this form and fax or email it to the office. Our fax number is 757-516-7032.  The email is moderneyesoptometry@gmail.com.

Change of Name, Address, or Insurance - We strive to keep our records up to date and keeping our patients informed on what's going on in the practice. If you have recently changed any of your personal information, please inform us of this change by filling out this form and sending it to us, along with a copy of photo ID, so that we may update our records.