PERFORMANCE VISION CENTER
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patient information forms

Patient Forms

Patient Information Forms
File Size: 171 kb
File Type: pdf
Download File

We ask all new patients (or former patients with changes to their current record information) to fill out our patient information form. Please send this form to the office prior to your appointment or bring it in with you on the day of your appointment.

​
     
**If the form is not filled out prior to your appointment, we ask that you arrive 15 minutes prior to your                         scheduled appointment time.  This will allow Dr. Ross to stay on schedule.

Things to bring with you to the appointment:
  • Your mask 
  • Patient information form
  • Glasses or contacts if you wear them
  • A list of any current medications.  
  • If you are a contact lens wearer and have the contact lens boxes or packages bring those as well.​

We look forward to seeing you soon!

Contact Us:
Performance Vision Center - Dr. Richard Ross
1708 Lee Road
Winter Park, FL 32789
Phone: 407-629-1174   Fax:  407-629-6117
Office Hours
Mon    8:30 am - 6:30 pm
Tue     8:00 am - 5:30 pm
Wed    8:30 am - 6:30 pm
Thu     8:30 am - 5:30 pm
Fri - Sun       CLOSED
*Open one Saturday a month, Call for Openings*
Notice of Privacy Practices
Website by Eyefinity
  • Home
  • COVID-19 PROTOCOLS
  • About Us
    • Why Did I Choose Optometry?
    • Why Get Glasses Here?
    • Privacy Notice
  • Our Services
    • Sports Vision >
      • Golf Tips
    • Orthokeratology (Ortho-K)
    • Eye Vitamins
    • Eye Care Articles
  • Patient Forms
  • Location
  • What's New?