Vision Care Patient Forms Salt Lake City Utah (UT) Rock Springs Wyoming (WY)

Contact Us

Our Office Locations

Salt Lake City Location
755 East 3900 South
Salt Lake City, UT 84107
800-760-4171

Patient Forms

All patients should bring a government issued ID and their insurance cards to each appointment. All new patients can download forms found below to assist the check-in process.

PATIENTS OVER THE AGE OF 50

Medical History
Patient Registration Form
Vision Preferences Questionnaire
Pre-Operative Visual Function Form
Information for Cataract Patients – Cataract Surgery and IOL Options
Cataract Interest Letter
Medical Records Release Form – if you would like to transfer your records from another office to The Eye Institute of Utah, please complete this form and either bring it to our offices or fax it to (801)268-6151.

LASIK PATIENTS & PATIENTS UNDER THE AGE OF 50

Lasik Pre-examination Instructions

Medical History
Patient Registration Form
Medical Records Release Form – if you would like to transfer your records from another office to The Eye Institute of Utah, please complete this form and either bring it to our offices or fax it to (801)268-6151.

SurgiCare Center Advance Notifications and Patient’s Rights

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Eye Institute of Utah