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

Close [x]

At Lock Family Eye Care, 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.

Medical History Forms - Required 

Please complete the following medical history forms to help us better understand your unique situation. 

Download & Print Medical History Front Form 1 

Download & Print Medical History Back Form 2 

Insurance Release Form 

The insurance acknowledgement form gives Lock Family Eye Care the authorization to filewith your insurance company

Download & Print Form 

Download the Free AdobeReader®

Exclusive Offer

Welcome to Lock Family Eye Care

Your Optometrist in West Des Moines, IA.

Office Hours

9:201 Jordan Creek Pkwy # 12190 West Des Moines, IA 50266
*M-F, we take the last appointment at 5:20pm

Day Morning Afternoon
Monday 9:20 6:30
Tuesday 9:20 6:30
Wednesday 9:20 6:30
Thursday 9:20 6:30
Friday 9:20 6:30
Saturday 9:20 4
Sunday 11:30 4