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®

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