Online Forms

At Bettner Vision, 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 AdobeReaderĀ® to download and complete the forms.
  • 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.

Medical History

Download & Print Form

Fill Out & Submit Online

Patient Intake

Download & Print Form

Fill Out & Submit Online


Financial Policy

Download & Print Form

Acknowledgement of HIPAA Privacy

Download & Print Form

Cancellation / No Show Policy

Download & Print Form

Optomap

Download & Print Form


Download the Free AdobeReaderĀ®

Contact Us

We look forward to hearing from you

Locations

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Hours of Operation

Our Regular Schedule

Bettner Vision

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

By Appointment Only

Sunday:

Closed