WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

At Owens Optometrics, we value your time. In an effort to save you time in our office, you can download and complete our patient forms prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click below to download.
  • 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 (717-355-2138) or bring them with you to your appointment.

Patient Health History Form – Required - Download & Print Form

  • 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 your have regarding your eye health or vision on the form.

HIPAA Authorization – Required - Download & Print Form

Financial Responsibility – Required - Download & Print Form


Download the Free AdobeReader®

Office Hours

DayMorning
Monday9:00 AM6:30 PM
Tuesday9:30 AM4:30 PM
Wednesday9:00 AM6:30 PM
Thursday9:00 AM6:30 PM
Friday9:30 AM12:30 PM
SaturdayClosed
SundayClosed
Day Morning
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00 AM 9:30 AM 9:00 AM 9:00 AM 9:30 AM Closed Closed
6:30 PM 4:30 PM 6:30 PM 6:30 PM 12:30 PM