New Patient Forms

Patient Forms

At Blue Valley Vision of Overland Park, we strive to make sure the time we spend with you during your visit is quality time.  In an effort to save you time and make the whole process smoother, we have provided access to new patient forms, which can be completed in the comfort of your own home.  Click the appropriate HIPAA compliant link below to complete and submit your paperwork prior to your arrival.

151st Street Location:  https://intakeq.com/new/1zs24e...

135th Street Location:  https://intakeq.com/new/1zs24e...

If you prefer to use our paper forms, follow the directions below:

New Patient Form

You will need AdobeReader® to download the form. Click here to download the Free AdobeReader

Computer saavy users can fill out the form online by following the steps below:

1. To begin click here
2. Click Free Online button to the left 
3. Click Load PDF from Internet; Copy and paste the following address into the Load URLbox: http://bluevalleyvision.com//m...
4. Add text by clicking on the text button located on the upper left-hand corner
5. Click on the freehand button to put a slash mark thru YES or NO and to check mark the boxes
6. Print out the form and add your initials + signature on the bottom
7. Bring your completed copy with you to your appointment.

Please feel free to review the HIPAA policy prior to completing the new patient form.