Forms

Optomap Policy

Our Optomap Retinal Screening Policy is effective October 1, 2020.

Patient Info Form

You can now fill out our Optix Optometry Patient Information form online using a simple link. You can even upload your health insurance card for a contactless option!

 

Don't worry - it's HIPAA compliant. Try it out here!

 

If you would rather print and fill out the form, simply print and fill out the form here.

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1850 Sagamore Pkwy W

West Lafayette, IN  47906

Tel:  765.743.3132

Fax:  765.743.2455

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© 2016 by Optix Optometry