Self-scheduling is currently available for select locations!

Patient forms

To save time at your visit, the following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save significant time at your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

New patient registration

Download
Medical records form

Download
Workman's compensation

Download
No-fault accident insurance form

Download
Neuro-ophthalmology patient history form

Download
HIPAA Financial Form

Download

Services offered at OCLI

Our world-class team of professionals at OCLI can help you with the latest treatment options for you.

Schedule an appointment

Please choose your preferred provider: *

Self-scheduling is not currently available for this provider, please complete form below and a member of the OCLI Vision team will contact you to schedule your appointment.

* required

First Name: *

Last Name: *

Date of birth: *

Email address: *

Cell phone number: *

Preferred location: *

Reason for appointment: *

The practices of OCLI Vision offer eye care services at locations throughout Connecticut, New Jersey, New York, Pennsylvania and West Virginia and specialize in primary vision care, LASIK, cataract surgery, glaucoma, diabetic eye care, and other services for patients in the Northeast.

Patient forms

New patient registration

Medical records form

Workman's compensation

No-fault accident insurance form

Neuro-ophthalmology patient history form

HIPAA Financial Form

Services offered at OCLI

Schedule an appointment

Please choose your preferred provider: *

Please complete the following to request your appointment:

Please complete the following to request your appointment:

Please complete the following to request your appointment:

Self-scheduling is not currently available for this provider, please complete form below and a member of the OCLI Vision team will contact you to schedule your appointment.