Online Forms

At Capital Eye Care, we offer patient forms online so you can complete them in the convenience of your own home or office. Fax or email us your completed forms or bring them with you to your visit.
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  • If you do not already have AdobeReader® installed on your computer, Click Here to download it now.

  • Download the necessary form(s) and fill in the required information.

  • Fax us your completed form(s) at 501-512-1524.

  • ​​​​​​​Email us your completed form(s) at info@capitaleyecarelr.com.

  • New Patient Form

  • DOWNLOAD

  • Notice Of Privacy Rights, Protection & Responsibilities

  • DOWNLOAD​​​​​​​

Once a form is completed, please upload using the file upload submission below:

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