New Patients & Forms
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.
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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 firstname.lastname@example.org 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 us at (904) 425-5075.
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