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(704) 875-8787 H
H

(704) 875-8787

Online Forms

At F.Y. Eye Care Associates, we value your time. In an effort to save you time in our office, 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.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals your have regarding your eye health or vision on the form.

Download & Print Form


Notice of Privacy Practices

Download & Print Form


HIPPA Release Form

Please complete this form if you would like anyone besides yourself (or parent/legal guardian for patients under 18 years of age) to have access to your protected health information.

Download & Print Form


Download the Free AdobeReader®

Sign up using the form below or call (704) 875-8787 to make an appointment.

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Office Hours

DayMorningAfternoon
Monday8:40AM - 1PM2PM - 5PM
Tuesday9:45AM - 1PM2PM - 6:30PM
Wednesday8:40AM - 1PM2PM - 5PM
Thursday8:40AM - 1PM2PM - 5PM
Friday8:30AM - 1PMClosed
SaturdayBy appt only
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:40AM - 1PM 9:45AM - 1PM 8:40AM - 1PM 8:40AM - 1PM 8:30AM - 1PM By appt only Closed
2PM - 5PM 2PM - 6:30PM 2PM - 5PM 2PM - 5PM Closed Closed