If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site

WARNING

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

Close [x]

Call Us Today

352-728-8318
m

At Beacon Advanced Eyecare Center, 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 the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patients  - Please fill out New patient and Signature on file forms and bring/send to the office.

Returning Patients - Please fill out Returning patient and Signature on file forms and bring/send to the office.

New Patient Form

Returning Patient Form

Signature on File Form

Patient Record Release Leesburg

Patient Record Release Lady Lake
 

Featured Services

Services
We strive to provide complete care for our patients. Learn more about all the services we provide.
Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.