Lafayette Family Eye Care

Patient Forms


Patient Forms

Please fill out the information sheets for your age bracket. Conveniently submit the forms online or print them and bring them with you to your appointment.


Adult Information Sheets

(18 Years or older)

PDF Version

Children's Information Sheets

(17 years or younger)

PDF Version

Obtain / Release
Medical Records

(All patients)

PDF Version

Privacy Practices Form

(All patients)

PDF Version
  • Eyezen+ Lenses

  • Eyezen+ Lenses

    Eyezen+ lenses are an enhanced, everyday pair of single-vision lenses that are a more complete solution to modern vision problems in our digital world. The accomodative relief provided by these lenses help defend against digital eye strain caused by hours of viewing near objects such as tablets and smart phones. They also contain Essilor's Smart Blue Filter™ feature, which blocks at least 20% of harmful blue light from digital devices, indoor lighting, and even the sun.

    Ask your doctor if the Eyezen lens is the right fit for meeting your daily visual demands with less eye strain, less eye fatigue, and more visual comfort.

    Learn More