Appointment request

Key Information Optometrists Collect

• Personal details: Full name, date of birth, address, phone number, and emergency contact.

• Medical history: General health conditions (e.g., diabetes, hypertension), past surgeries, allergies.

• Vision concerns: Current issues such as blurred vision, headaches, double vision, or eye strain.

• Corrective lenses history: Whether the patient currently uses glasses or contact lenses, and prescription details.

• Medication list: Current medications, dosage, and any eye-related treatments.

• Family eye health history: Conditions like glaucoma, cataracts, or macular degeneration in close relatives.

• Insurance information: Provider details, policy number, and coverage specifics.

• Consent and lifestyle details: Consent for treatment, plus lifestyle factors such as screen time, occupation, or exposure to UV light