Online Forms

At Ft. Pierce Vision 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 AdobeReader® to download and complete the forms. Click here to download.
  • 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.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health by either typing in your answers or using black ink only. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form.

Fill Out & Print Form

Our Location

828 South US Hwy 1, Ft. Pierce, FL, 34950

Our Hours