Online Forms

At 50 Dollar Eye Guy, 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 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.

Download & Print Form


Download the Free AdobeReader®

FREE EYE EXAM with purchase of complete pair of glasses. Or bring you DR's RX and receive $59 OFF your eyeglass purchase!

Sign-up using the form or call us at 850-434-6387 to take advantage of this exclusive offer. Only at 5328 North Davis location.

Davis Highway Location

Monday
9:00 am - 6:00 pm
Tuesday
9:00 am - 6:00 pm
Wednesday
9:00 am - 6:00 pm
Thursday
9:00 am - 6:00 pm
Friday
9:00 am - 6:00 pm
Saturday
10:00 am - 5:00 pm
Sunday
Closed Closed

Davis Highway Location #2

Monday
9:00 am - 6:00 pm
Tuesday
9:00 am - 6:00 pm
Wednesday
9:00 am - 6:00 pm
Thursday
9:00 am - 6:00 pm
Friday
9:00 am - 6:00 pm
Saturday
10:00 am - 5:00 pm
Sunday
Closed