For your convenience, you can download and complete the three forms we will need prior to your appointment. Quick, easy, directions included.

  • You can complete the forms on your computer or by hand.
  • You can email the forms to kirklandvision@live.com  before your appointment or bring them with you.

Kirkland Vision Center Patient Forms 2017


  1. Medical Registration
  2. Retinal Photography
  3. Estimate of Charges for Contact Lens Services

Directions

Once you have clicked the link above, hover your mouse in the bottom right of your computer screen to display the tool bar.

PDF Tool Bar
PDF Tool Bar

If you have Adobe XI or similar PDF software, you can complete the forms on your computer by saving the file. Do not select the print option as the fillable forms will not be active.

To sign electronically, you must have a digital signature. You can create a digital signature within the documents by clicking on the signature field. For further instructions, see the video Creating a Digital Signature for PDF Documents.

Should you want to complete the forms by hand, you can print the document.

Either bring the forms to your appointment or return them by email at kirklandvision@live.com 

You can also sign the documents by hand or, if emailed, at the time of your appointment.