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Online Forms

At Visionelle Eyecare, we value your time. In an effort to save you time in our office, we've provided you with three ways to complete your patient paperwork.

  1. You can Click Here to access your vision health information. Your login information will be provided to you by our office once you've made your appointment with us. If you have a username, but are having trouble logging in, you can contact us at (317) 769-3937 and we'll get you set up with a new temporary password.
  2. Alternatively, if you are having trouble logging in and aren't able to contact us before your appointment, or it's after hours, you can download and complete our manual patient form(s) prior to your appointment. You will need AdobeReader® to download and complete the forms. See the links below.
  3. Finally, if either of the above don't work you can always fill in your paperwork when you come in for your appointment. We just ask that you arrive 10-15 minutes prior to your appointment time so that you'll have enough time to complete the paperwork before you see the doctor.

New Patient Health History Form

  • 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 at (f) (317) 769-2439 or bring them with you to your appointment.

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 you have regarding your eye health or vision on the form.

Download & Print Your New Patient Paperwork

Download the Free AdobeReader®

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