Fillable Optometry Intake Form – Digital, Customized PDF 🖊️👁️
Upgrade your intake process with this fully fillable PDF optometry intake form, designed for modern, paperless workflows. Whether you're launching a new clinic or streamlining an established practice, this digital form makes it easy to collect patient information clearly and efficiently—no printing required.
With a clean, intuitive layout, this form covers everything you need in one file: standard health history, contact lens wearers’ details, a built-in dry eye questionnaire, and space for pretesting notes.
Why you'll love it:
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Fully fillable PDF – no handwriting or scanning needed
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Easy to email, upload to tablets, or integrate into digital workflows
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Organized and patient-friendly layout
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Includes all key intake areas in a single document
Perfect for:
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Paperless optometry offices
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New practices building digital systems
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Updating outdated or hard-to-read handwritten forms
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Clinics specializing in contact lenses or dry eye
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Streamlining intake and pretesting documentation
Size: US Letter Portrait (8.5 x 11 in), printed on 24 lb laser paper (90 gsm)
Listing price covers cost for printed documents, shipping, and customization (adding office logo and necessary information and altering colors to match branding).
This listing is for a customized fillable PDF file. For printed version, click here.
Special Notes: Please attach logo prior to purchasing!
