Patient Paperwork

We look forward to seeing you at your appointment!  Get the most out of your visit by completing your paperwork online in advance.

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, or sign a copy in the office when you arrive for your appointment.

Submit Paperwork Online

For New Patients, you can submit your paperwork online here

For Established Patients, you can submit your paperwork online here


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.

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.

Some other things to consider before you come in for your eye examination:

  • Dilation is an important part of a complete and comprehensive exam. It is highly recommended by both of our doctors and since it leaves near vision blurry for a few hours, you might bring a driver, or arrange for a ride if you are uncomfortable driving with dilated eyes.

Please make sure you bring:

– Glasses, Medication list, vision and medical insurance cards, and contact lens information if applicable