Modern Optometry Intake Form – Streamline Your Patient Workflow 🖊️👁️
Upgrade your intake process with a sleek, professional form designed for today’s optometric practice. Whether you're opening a new clinic or replacing outdated paperwork, this all-in-one intake form helps simplify patient onboarding while supporting efficient documentation for your team.
What’s included:
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Standard health history section
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Dedicated space for contact lens wearers
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Built-in dry eye questionnaire
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Pretesting notes section
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Clean, easy-to-read layout for quick completion
Ideal for:
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New or growing optometry practices
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Offices modernizing outdated forms
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Clinics specializing in contact lenses or dry eye
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Teams focused on efficient, patient-centered care
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Staff training and consistent documentation across providers
Customizable and easy to implement—designed with your workflow in mind.
How it works:
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Purchase and download the Canva template link
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Customize with your practice branding and details
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Save, print, or share digitally with your patients
Template Size: US Letter Portrait (8.5 x 11 in)
Want to save some trees? Check out the fillable PDF version of this intake form instead!
