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Online Forms


At Family Vision Care Associates, 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.
  • 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 Patient Medical History for Adults / Students

*ALL NEW PATIENTS, please print and complete one of the two Medical History Forms listed below and bring it with you to your appointment.

Print / Complete / Sign - ADULT Medical History Form
Print / Complete / Sign - STUDENT Medical History Form


Notice of Patient Privacy

Please READ the NOTICE OF PRIVACY PRACTICE: Read Online | Download/Print
Print / Sign - HIPAA ACKNOWLEDGEMENT


Other Forms

If you wish to give authorization to someone so that we may discuss your health record and billing pertaining to our office with them, please:

Print / Complete / Sign - HIPAA PRIVACY AUTHORIZATION

If you wish to give us authorization to release your medical record to another doctor or entity, please:
Print / Complete / Sign - RECORD RELEASE

If you wish to give us authorization to exam/treat your minor child without a parent being present, please:
Print / Complete / Sign – PARENTAL CONSENT FOR MINOR


InfantSEE Program

If you wish to take advantage of a comprehensive vision exam for your infant (The InfantSEE Program), please use the forms (English or Spanish) listed below:

Print / Fill Out InfantSEE Form - English


Download the Free AdobeReader®

Location

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Hours of Operation

Our Regular Schedule

Monday:

9:00 am-5:00 pm

Tuesday:

8:00 am-5:30 pm

Wednesday:

8:00 am-1:00 pm

Thursday:

9:00 am-5:30 pm

Friday:

8:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

  • "This morning I woke up unable to see with my contacts in, Of course, as any one would, I freaked out. I called every eye doctor I could find. Everyone was so busy. But at FVC they told me to come right in,. Not only did they squeeze me in on short notice, but they went above and beyond. They were incredibly thorough and caring, as I was clearly very nervous. I left there knowing exactly what was going on, and with such peace of mind. I would recommend this place 100x over. Every single person was so kind and warm the minute i walked in the door. Needless to say, I will not be going elsewhere ever again."
    Shaylyn L. - Google (5 Stars)
  • "Stellar, thorough and considerate care!"
    Kaye J - Google (5 Stars)
  • "Dr. Paul is amazing! He's kind, has a wonderful sense of humor, and my daughter (who is cautious and shy) really likes him. At recess my daughter had a ball hit her in the eye - and Dr. Paul took her in the office immediately and discovered she had a scratched cornea. He showed her how to put eye drops into her eye herself - and within a 1/2 hour we we finished, on our way back to school with all the eye drops she needed to prevent infection and keep her eye lubricated. She also takes vision therapy with him and is making incredible progress."
    Daphne R. - Google (5 Stars)
  • "I have been a patient at Family Vision Care Associates for 24 years. Dr. Paul Bernstein and his staff are outstanding. They really go above and beyond to make your experience as wonderful as possible. They are very knowledgeable and are always current with the new technology. In my lifetime, I've transitioned from wearing glasses, to contacts to Lazik and I couldn't have done it without Dr. Bernstein. He's been a wonderful help in adjusting to all the changes and I'm grateful for all the support I've gotten over the years from him and his team. If you're looking for an experienced and reliable doctor who's patience and kindness go above the norm, look no further!!"
    Renata M. - Google (5 Stars)