Patient Forms | Eye Care St. Louis | Pepose Vision Institute

Patient Forms

We would like to help make your appointment with us as convenient for you as possible.

In order to expedite your check-in process, we have provided forms for you to complete in advance of your visit.

Please fill out the appropriate forms and bring them at the time of your appointment, along with a photo ID and medical insurance cards.

If you are a New Patient, please click the form below.

Pencil and Paper

If you are a Returning Patient, please click the form below.

Pencil and Paper

 If you are a New LASIK Patient, please click the form below.  

Pencil and Paper

Please click below to review and acknowledge our 24 Hour Cancellation & “No Show” Fee Policy. 

Pencil and Paper

Please click below to review and acknowledge our COVID Treatment Consent Form.  

Pencil and Paper

Please click below to take our Dry Eye and Allergy Patient Impact Questionnaire.  

Pencil and Paper

Please click below to review and acknowledge our Notice of Privacy Practices. 

Pencil and Paper

Need help?

If you need assistance completing your new patient form, please contact us.
We’ll be happy to help you so that we can make it more convenient for you when you arrive for your appointment.

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