Online Forms

At Dr. Blacks' office, we value your time. In an effort to save you time in our office, you can submit your medical history form online or download and complete it and bring it to your appointment. 

Patient Health History Form - Submit Online


Patient Health History Form – Required

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.

  • 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 and bring them with you to your appointment.

Patient Health History Form - Download & Print Form


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Exclusive Offer

Buy 1 complete pair of glasses (frame and lenses) and receive a 30% discount on a second pair that same day.

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Hours of Operation

Our Regular Schedule

Monday:

8:00am

5:00pm

Tuesday:

8:00am

6:00pm

Wednesday:

8:00am

5:00pm

Thursday:

8:00am

4:00pm

Friday:

8:00am

5:00pm

Saturday:

Closed

Sunday:

Closed

Location

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Testimonials

Reviews From Our Satisfied Patients

  • "I was very impressed with Dr. Kayla Black. I went there for the 1st time and she was very thorough and went above and beyond. Michelle was very friendly, helpful, and went over insurance details. I highly recommend! Thanks to Cindy Ewing for the referral."
    Rachelle Randle Christian
  • "As always very caring and respectful, I would recommend to anyone even though I don't have insurance to cover the cost well worth it and 20% discount for cash customers."
    Chris Wence

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