Optometry Health Questionnaire – Modern Intake Form for Patient History 👁️🖊️
Upgrade your patient paperwork with this professionally designed health history questionnaire, created by an optometrist specifically for use in modern eye care practices. This clean, easy-to-complete form helps streamline your intake process while supporting thorough and consistent documentation.
Whether you're launching a new practice or replacing outdated forms, this questionnaire delivers a polished, organized look that fits seamlessly into today’s workflows.
Why it works:
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Covers essential medical and ocular history
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Clean, professional layout for easier completion and review
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Helps reduce intake bottlenecks and improves documentation accuracy
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Designed with the needs of real-world optometry practices in mind
Perfect for:
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New or growing optometry practices
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Replacing outdated or inconsistent paperwork
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Supporting front desk and technician efficiency
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Creating a strong first impression for new patients
A simple, professional way to elevate your intake experience and improve patient flow.
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: Portrait Flyer (8.5 x 11 in)
Want to save some trees? Check out the fillable PDF version of this intake form instead!
