Online Forms

Online Web-Registration Link: Click Here 

At Vision City of Lake Worth, we value your time. In an effort to save you time in our office please fill out the online web-registration link, if that does not work you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

Download the Free AdobeReader®

Patient History Form

Notice of Privacy Practices (This one does NOT have to be printed. You can just read it)

Acknowledgement of Receipt

Optional Tests

Signature on File

Contact Us

We look forward to hearing from you.


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Hours of Operation

Our Regular Schedule


9:00 am-6:00 pm


9:00 am-6:00 pm


9:00 am-6:00 pm


9:00 am-6:00 pm


9:00 am-6:00 pm


9:00 am-2:00 pm


Appt Only