DE Vision Academy Online Patient Forms

Delaware Vision Academy is pleased to offer online forms. All patients are asked to provide updated information prior to each visit with the doctor.

NEW PATIENTS - If you are a new patient, please call the office to schedule an appointment and to obtain a passcode to fill out the forms online.

EXISTING PATIENTS - If you are an existing patient, please call the office at 302-998-1395 and we will provide you with login information to review and update your previously provided information.




DE Vision Academy Patient Forms

These forms provide additional information that is not included in the online forms. Please print on one side, fill out, and bring in for your appointment.

Developmental Visual Forms

These forms are for patients who are having difficulty reading, tracking, scanning, or focusing without a head injury.

Vision Therapy Progress Evaluation

These forms are for patients currently being monitored or treated by the doctor for developmental or trauma vision conditions. They may be doing home support activities or in-office therapy.

Head Injury/Trauma (Stroke/Automobile Accident/Workman's Compensation)

Important Insurance Information