Online Forms

At Advanced Family Eye Care PC, 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.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History 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 you have regarding your eye health or vision on the form.

Download & Print Form or Fill Out Online


Download the Free AdobeReader®

Locations

Hours of Operation

St. Joseph Location

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Benton Harbor Location

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

South Haven Location

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Stevensville Location

Monday

9:00 am - 5:00 pm

Tuesday

9:00 am - 5:00 pm

Wednesday

9:00 am - 5:00 pm

Thursday

9:00 am - 5:00 pm

Friday

Call for Appointment

Saturday

Closed

Sunday

Closed

St. Joseph Location

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Benton Harbor Location

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

South Haven Location

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Stevensville Location

Monday
9:00 am - 5:00 pm
Tuesday
9:00 am - 5:00 pm
Wednesday
9:00 am - 5:00 pm
Thursday
9:00 am - 5:00 pm
Friday
Call for Appointment
Saturday
Closed
Sunday
Closed