If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site

WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Follow Us

At Lafayette Eye Associates, we value your time. In an effort to save you time in our office, please download and complete the returning patient forms below prior to your appointment. Please remember to bring the completed patient information form, your medical insurance card, vision insurance card (if applicable) and driver's license or ID with you for your appointment and to complete the patient interview on the patient portal in advance of your scheduled appointment.

Patient Information Form* 

Download and Print Patient Information Form

  • You will need AdobeReader® to download and complete the form. Click here to download.
  • Download the required form. Print out the form and complete the required information.
  • Fax your printed and completed form to our office or bring them with you to your appointment.

On-line Patient Interview on Patient Portal* 

Lafayette Eye Associates is pleased to offer our patients the latest in healthcare technology including our new online patient portal accessible at RevolutionPHR. The benefits are many including the ability to confirm your demographic and appointment information.  It also enables you to complete required eye health interview questions in advance of arriving at our office from the convenience of your own home computer. Please make sure to complete the interview in advance of your appointment on the patient portal.

If you have not already created your patient portal profile, please call our office today so that we can help you set one up.

*Required by all new and returning patients for annual, comprehensive and problem visits if not already completed in this calendar year

Click Image below to Login


Download the Free AdobeReader®