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HENRYETTA EYE CENTERA Member of

Patients

Patient Forms

Save time at your appointment by completing forms in advance.

Privacy notice: Do not send protected health information through this website unless you are redirected into a secure patient portal or verified HIPAA-compliant intake system.

Downloadable Forms

Download, print, and bring completed forms to your appointment to save time at check-in.

📄New Patient Form PDF

Online Forms

Secure Digital Forms Pending Integration

Until secure digital intake is connected, please use the downloadable PDF or the patient portal for protected information.