Please do not use this system if you are experiencing an ocular emergency.
If you have an eye injury, sudden onset of flashes or floaters or sudden loss of vision, please call the office immediately (540) 953-2020.

Online Patient forms

Online Patient Forms

New Patients/Patients without Passcode

Please complete the online forms before your office visit.


(If you are not able to complete these forms online, then please contact our office at (540) 953-2020 at least 5 days before your scheduled appointment)

Existing Patients

Please enter the passcode supplied by the office to prepopulate your most recent information.

Passcode:

Online BIVSS Patient forms

Online BIVSS (Brain Injury Vision Symptom Survey) Patient forms

New Patients/Patients without Passcode

Please complete the online forms, before your office visit.