New Patients & Forms

Welcome to Pediatric Eye Consultants of North Florida!

Thank you, we appreciate your time and look forward to meeting you. To expedite your registration process, our New Patient Forms are available online. We request that you take a few minutes to open and complete each form, then either send it to us via email or print and fax prior to your first appointment.

Patient Registration

All new patients will receive a patient registration link approximately 3 days prior to your appointment via text or email.

Complete Forms Online

Once opened in your browser, you may use your keyboard and mouse to completely fill out each form. Save a copy of the completed form and either email it to or print and fax them to (904) 425-9414. If you are faxing the forms to us, please be sure to sign each Signature field manually. If sending by email, we will request your signature at time of registration. If you have any questions, please call or text us at (904) 425-5075.

Free Download: Adobe Reader

All browsers do not support filling form fields online. Download a forever free copy of Adobe Reader here! Download Adobe Reader

Patching Pirate App for iPhone and iPad

Download the Patching Pirate App and make patching fun! Developed by an Orthoptist with 30 years’ experience patching children, Patching Pirate will encourage and motivate your child to patch. Your child can earn gold from patching to buy accessories for their avatar. Download Here