Visionary Eye Center East

(561) 429-8753

Visionary Eye Center West

(561) 250-0655

Online Forms

At Visionary Eye Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReaderĀ® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Office Policies & Procedures

Download & Print Form

Optical Policies & Waiver Form

Download & Print Form

Referral from PCP Authorization Request

Download & Print Form

RightEye EyeQ Test Intake Form

Download & Print Form

Wellness Photo and OCT Consent

Download & Print Form

Contact Lens & Specialty Fit Policy 

Download & Print Form

Advance Beneficiary Notice of Non-coverage (ABN)

Download & Print Form - English || Download & Print Form - Spanish 

All Sales Are Final

Download & Print Form

Commercial Insurance Advance Beneficiary Notice

Download & Print Form

Contact Lens Prescription Signed Acknowledgement Form

Download & Print Form

HIPAA Acknowledge & Dilation Consent

Download & Print Form


Download the Free AdobeReaderĀ®

Locations

Find us on the map

Hours of Operation

Monday

9:00 am - 5:00 pm

Tuesday

10:00 am - 6:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

10:00 am - 6:00 pm

Friday

9:00 am - 5:00 pm

Saturday

9:00 am - 2:00 pm

*alternate 2 / month

Sunday

Closed

Monday
9:00 am - 5:00 pm
Tuesday
10:00 am - 6:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
10:00 am - 6:00 pm
Friday
9:00 am - 5:00 pm
Saturday
9:00 am - 2:00 pm *alternate 2 / month
Sunday
Closed