Accessibility View Close toolbar

Online Forms

At Lakepointe Vision 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. 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 (618-624-3940) or bring them with you to your appointment.

NEW PATIENTS

Welcome Form

Medical History

Social History

Office Policy

Financial Agreement

ESTABLISHED PATIENTS

Welcome Form

Social History

Office Policy

Patient Medical Record Release

Financial Agreement

MISCELLANEOUS FORMS

Medical Record Release

Medical Record Request

Contact Lens Policy


Download the Free AdobeReaderĀ®

Contact Us

We look forward to hearing from you.

Location

Find us on the map

Hours of Operation

Our Regular Schedule

Monday:

8:30 am-5:00 pm

Tuesday:

12:00 pm-7:30 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-5:00 pm

Friday:

8:30 am-5:00 pm

Saturday:

Closed

Sunday:

Closed