At Kueber Eye Care, 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.
  • Email your printed and completed form(s) to our office or bring them with you to your appointment. 

[email protected]

HIPAA Privacy Policy

Download & Print Form

Authorization to bill Insurance

Download & Print Form

Medical History Form

Download & Print Form

Download the Free AdobeReaderĀ®