Patient Forms

What to Expect

When you visit our office, you will be warmly welcomed and we can answer any questions you may have about completing the paperwork so that Pupila Family Eye & Ear Care may see you. Our team will work together to evaluate your eyes and provide relevant eye care treatment information, review your vision benefits and payment options, fit you for glasses or contact lenses, and focus on exceeding all of your expectations. If at any time you have questions about the process or your specific health information, please ask.

At Pupila Family Eye & Ear Care, 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.



​​​​​​​As of January 1, 2023

There will be a $50 canelation fee, for the last minute cancelations and no shows.

If you need to cancel or reschedule your appointment, it must be done a minimum of 24 hours in advance.

No future appointments will be made until the fee is paid.

Thank you!