Accessibility View Close toolbar

Online Forms

At Dr. Lotz's office, 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. Click here to download.
  • Download and print out the required form(s).
  • Bring the completed form(s) with you to your appointment.


Dr. Lotz's Patient History Questionnaire – Required


Vision Service Plan Patient History Questionnaire – Required if you have Vision Service Plan

Notice of Privacy Practices - Please Read


Download the Free AdobeReader®

New Patients Receive 15% OFF Second Pair of Complete Glasses!

Location

Find us on the map