Online Forms

Online Forms

Download the necessary form(s), print it out and fill in the required information. Please fax us your printed and completed form(s) or bring it with you to your appointment.

Online Welcome Form (REQUIRED) - Submit Online*

Infant Vision History (Optional) - Download & Print

Contact Lens Handling (Optional) - Download & Print

Dry Eye Questionnaire (Optional) - Download & Print

HIPPA (Optional) - Download & Print

*Please note that in order to protect your medical privacy, you will be directed to another website. Thank you!

Notice of Nondiscrimination - Section 1557-Affordable Care Act(ACA)
Belleview Eye Associates complies with Federal civil rights laws and does not discriminate on the basis of race, color, national orgin, age, disability or sex.

May 1st, 2020

We will be reopening effective Tuesday May 12th! We are glad to be back and looking forward to providing our patients with the exemplary care you have come to expect in the safest environment possible.

While our doors will be open, we will have some changes in effect per guidelines from the CDC and the American Optometric Association.

We are asking patients to CHECK IN prior to entering the office. We will have a check in station set up where we will conduct a health screening questionnaire and your temperature will be checked.

We are requiring that all patients over the age of 2 wear a FACE MASK.

SOCIAL DISTANCING will be required and our staff will approve entry in order to control the number of people in the office. Please wait for staff approval before entering the office.

In order to maintain our social distance guidelines, we will be allocating ONE HOUR for the exam, shopping, and checkout. If you need more time to find the perfect pair of glasses we will be adding specialized shopping times.

If you had an appointment that was cancelled due to the COVID 19 closure, please contact our office at 303-979-3937 so that we can reschedule your appointment.

Thank you! We look forward to "seeing" you all again! :)