Patient Resources

Patient Forms

Our patient forms are specified for children and adults. Please be sure to download and fill out the appropriate form to the best of your ability. You can print and bring them to your appointment. Thank you!

1

Child Intake Form

2

Adult History Form

Appointment Policies


Please book an appointment through our website or by giving us a call.

A vision therapy evaluation is allotted for 1 hour due to the case history review and extensive testing Dr. Aquije provides. After the in-person visit, a virtual conference will be scheduled for another day to discuss results. Here are some tips to prepare for your visit:

  • Filling out the patient intake forms ahead of time or arriving 15-20 minutes early will prevent delays and allow the doctor to use the full hour for the evaluation.

  • Bring a copy of your prescription (glasses/contact lens) from your last eye exam.

  • If a dilation or a photo of the back of your eyes has not been completed in the past 3 years, the doctor may need you to return for a follow up to complete this.

  • It’s normal to feel tired after the visit due to how straining some of the testing may be - we recommend you take it easy after and avoid jumping back into work right away.

  • Your vision insurance will not cover this visit. Dr. Aquije also does not participate with any medical insurance plans. Insurance companies will dictate the treatment and time that our patients receive. This is not acceptable to our office. We will provide you with the proper codes to discuss with your carrier should you choose to submit to insurance.