Online Forms:  

Please fill out demographics, insurance information (both vision and medical) and your medical and ocular histories online before your exam.  There are tabs for each of these.  After filling in your information, select the final tab labeled "submit data" and then select the "submit data" button. With our transition to electronic health records we are asking every patient to fill out their information online, even if you have been a patient at our office in the past.  The first time you fill out this information select "New Patient" to access the online forms.  For future exams, you will be able to access your own personal information, using a passcode in the area labeled "existing users", and simply be able to edit for any changes. 

The link below will take you to our secure website.

      

   Fort Lupton Vision Center Online Forms


Please call if you have any difficulty accessing this website or if you have any other questions.    Phone = 303 857 6550


If it is not possible to access the online forms, please print and fill out this form.  Then bring it to our office on the day of your exam.

Other suggestions:

- Bring all pairs of glasses you use regularly, including your prescription sunglasses or computer glasses.

- If you know your previous contact lens prescription (brand, power, base curve), please bring this information.