Patient Paperwork

Due to COVID-19, we are requesting that all patients submit paperwork online prior to their appointment.


Submit Paperwork Online

For New Patients

For Established Patients


PDF Files

If you don’t want to submit your paperwork online, you can print and fill out the following forms and bring them with you to your appointment.

Routine Vs Medical Eye Exams **

In an effort to assist our patients in navigating the ever complicated realm of insurance, we have created a document explaining the difference between Routine and Medical Eye Exams.

** Please review the following PDF prior to your Annual Eye Exam. You may print it out, sign it, and bring it to your exam.

New Patients (PDF Files)

Established Patients (PDF Files)

Pediatric Patients (PDF Files)


Records Release

If you are transferring care either to or from Chapel Hill Eyecare, feel free to use our records release form.