261 Alexander Street

Rochester, NY 14607

(585) 325-3070

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A great resource for all your eyecare questions!

Online Forms

At Alexander Eye Associates & Optical, 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 the link below to download.
  • Download the required form(s). You may print out and complete the form, or fill it out on your computer.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment. If completed on your computer, you may email your form to [email protected]
  • Bring this form, along with your current insurance card(s), identification card/driver's license, and current list of medications 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. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form

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