Patient Welcome Forms

Urban Optiks Optometry is now utilizing a HIPAA-secure online patient portal for completing pre-examination paperwork.  All patients will be asked to use this portal to complete their demographics, insurance and health history.

To access the portal, click the link below.  You will be asked to create an ID & password.  Please keep this info for future appointments.  Once logged in, you will be guided through the patient paperwork process completely online.  After it is completed, we will receive a copy to enter in your file.

For returning patients, we ask that you still fill out the form completely and thoroughly each year so we can monitor it for changes.

We kindly ask that you complete this prior to your appointment so that we may see you promptly and provide faster service.