Please take the time to fill out these forms before you visit us at Hellerstein & Brenner Vision Clinic, so that we can make your appointment with us more enjoyable and personalized for your specific vision needs!
Supplemental Forms in Addition to Online Registration:
Please print form, complete and bring to your first office visit.
- Sensory History Form (Additional form for children up to 18 years old)
- Answers to Your Questions on Vision Therapy
- Vision Therapy Progress Questionnaire – Child
- Vision Therapy Progress Questionnaire – Adults
- Vision Therapy Fees
Patient Info (Q & A)
Doctor Referral Forms
- Referral Form (For ODs & MDs)