Birch Run Eyecare Associates Online Forms

At Birch Run Eyecare Associates, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
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  • If you do not already have AdobeReader® installed on your computer, Click Here to download it now.

  • Download the necessary form(s) and fill in the required information.

  • Fax or email us your completed form(s) or bring them with you to your appointment.

HIPAA and Consent form
Download
Consent to treat minor children
Download
Retinal Health Screening Opt-In/Opt-Out Form
Download
Important Details for Your Upcoming Eye Care Appointment
Download