Online Forms

At Northwest Eye Doctors, 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 or Email your printed and completed form(s) to our office (preferred) or bring them with you to your appointment.

Patient Intake 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. Please email or fax (778)394-6935 the forms prior to your visit.

Download & Print Intake Form


Tele-Health Consent Form – Required for Virtual assessment via phone or video

Please complete this form and email or fax (778) 394-6935 to the clinic before your virtual appointment with the doctor.

Download & Print  TeleHealth Consent Form

If you are unable to assess the forms online, then please call the clinic (778) 394-6933 and we can email you the forms directly.


Download the Free AdobeReader®

Our Location

Address

#105 - 13737 96 Avenue,
Surrey, BC V3V-0C6

Phone

778-394-6933

We look forward to hearing from you.

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Please do not submit any Protected Health Information (PHI).

Monday  

9am - 5pm

Tuesday  

9am - 5pm

Wednesday  

9am - 5pm

Thursday  

9am - 5pm

Friday  

9am - 5pm

Saturday  

Closed

Sunday  

Closed

#105 - 13737 96 Avenue Surrey, BC V3V-0C6