Online Forms
Eyes on the City offers our patient form(s) online so they can be completed in the convenience of your own home or office.
New Patient Health History Form - Required
This lets us know the history and current state of your health and asists us in billing insurance. What questions, concerns, goals, regarding your vision can we help you with? Let us know!
- Print out the necessary form and fill in the required information.
- Fax/email us your completed form or bring it with you to your appointment.
Sammamish: 425.898.9880 infoeast@eyesonthecity.com
Ballard: 206.432.9751 infowest@eyesonthecity.com
