Health Tracking Forms
79 Templates
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Eye Prescription Form
About this template
An eye prescription form is used by eye doctors to record and refer to the patient’s prescription. This form, also known as a prescription for glasses or contact lenses, is a document that contains information regarding a patient's visual acuity and corrective lens requirements. The prescription form may also include instructions for the dispensing of the lenses, such as the recommended frame size, the fitting height, and any other specific requirements.
Whether you’re an optometrist or a medical office, use this Eye Prescription Form to record a patient’s prescription and allow patients to refer to it later. Upload your logo or a custom background image, select a form theme, and customize the template fields to match your medical practice — then embed it on your website or share it with a link. This form is ideal for referrals, so it’s easy for patients to print out and take to their next appointment.
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