Centerville Family Eye Care ~

Dr. Jeff L. Chandler and Dr. Lisa M. Timmerman

Patient Forms

The following forms are available for your convenience.
Please print all three forms, fill out, and bring to our office.

 
Questionnaire

Medical History Form

 Office Policies

As a reminder, your eyes may be dilated during your examination. 

You may want to bring a pair of sunglasses with you.

Please bring with you a list of the medications you take and your insurance card.

Also, if you are a new patient and wear contact lenses,

please bring an old box or old prescription of your contacts. 

Thank you!