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Click ‘Get Form’ to open the Personal Eye History: document in the editor.
Begin by entering your Patient Name and Date at the top of the form. This personal information is essential for accurate record-keeping.
In the 'Personal Eye History' section, specify your reason for visit and provide details about your last eye exam. Indicate whether you wear glasses or contacts, and if so, specify the type and brand of contacts used.
Answer questions regarding computer usage, including hours spent daily and any symptoms experienced like sore eyes or headaches. This information helps assess your visual comfort.
Check any symptoms you are currently experiencing from the provided list, such as blurred vision or dry eyes. This assists in identifying potential issues.
Complete the Medical History section by detailing any existing conditions, medications, and allergies. Be thorough to ensure comprehensive care.
Finally, fill out the Family History section to note any hereditary eye conditions that may be relevant to your health assessment.

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