THE FORT MYERS EYE CENTER
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Online Patient Forms

Save time during your appointment by completing our patient forms online. 
Below, you'll see the login page. (If this is your first visit, we'll take a few seconds to help you create a login to our site).
Secure Online Patient Forms

Download Patient Forms

Though we encourage you to use our convenient online patient form above, you are welcome to download, print, and complete the below forms prior to your appointment. We look forward to seeing you!
MEDICAL HISTORY FORM
File Size: 52 kb
File Type: pdf
Download File

CUESTIONARIO DE HISTORIA
File Size: 401 kb
File Type: pdf
Download File

Contact Us
Phone: 239-481-7799
Fax: 239-481-3739
e-mail us
1537 Brantley Road, Unit A-2
Fort Myers, FL 33907
Office Hours
Mon    8:30 am - 5:30 pm
Tue     7:00 am - 5:30 pm
Wed    8:30 am - 5:30 pm
Thu     8:30 am - 5:30 pm
Fri       7:00 am - 5:30 pm
Notice of Privacy Practices
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