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Is your child's prescription getting worse? We can help slow it down.Now welcoming new patients — all ages, including infants.Did you know your baby's first eye exam should happen between 6 and 12 months old?Up to 75% of children's vision problems are missed by vision screenings — only a full eye exam can catch them.Is your child nearsighted? Ortho-K can slow myopia progression by up to 50%.Is your child's prescription getting worse? We can help slow it down.Now welcoming new patients — all ages, including infants.Did you know your baby's first eye exam should happen between 6 and 12 months old?Up to 75% of children's vision problems are missed by vision screenings — only a full eye exam can catch them.Is your child nearsighted? Ortho-K can slow myopia progression by up to 50%.
Eye Medics Optometry
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Call 910.426.3937Request Appointment
Fayetteville, NCMon/Wed/Thu: 9AM–2PM · Tue: 1–4PM

New Patient Intake Forms

Save time at your visit — complete your paperwork online before you arrive.

What to Expect at Your First Visit

Comprehensive eye health evaluation (not just 20/20)
Discussion of your vision goals and concerns
Myopia risk assessment for children
Insurance verification and benefits review
Personalized treatment recommendations

What to Bring

Insurance card & photo IDAll major plans accepted
Current glasses or contactsSo we can review your Rx history
List of current medicationsIncluding eye drops
Previous eye exam recordsIf available
Arrive 10 minutes earlyOr complete this form in advance

Before Your First Visit

Please complete this form at least 24 hours before your appointment. Fields marked with * are required. Your information is transmitted securely and handled in accordance with HIPAA guidelines.

Prefer to print and bring it in?

Download the printable version and bring it to your appointment.

Download Printable PDF
Patient Info
Insurance
Medical History
Visit & Consent

Patient Information

Tell us about the patient who will be seen

Emergency Contact

Step 1 of 4

Questions About Your First Visit?

Our team is happy to help you prepare. Call us or request an appointment online.

Call 910.426.3937Request Appointment
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