Patient Forms

Two forms are typically needed for visits to ClearVue: a Medical History & a Disclaimer.

SCROLL DOWN to complete a combined form online and submit it electronically.


Alternatively, use the links below to download our forms.

You can email them to us at hello@clearvue.org,or bring them to your visit.

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  • Type the content for this list item here. This is just example text to show you what it will look like when you enter text content into this list item. Your unique, authentic, and appropriate text will be filled into this section.

  • Type the content for this list item here. This is just example text to show you what it will look like when you enter text content into this list item. Your unique, authentic, and appropriate text will be filled into this section.

  • Type the content for this list item here. This is just example text to show you what it will look like when you enter text content into this list item. Your unique, authentic, and appropriate text will be filled into this section.

  • Type the content for this list item here. This is just example text to show you what it will look like when you enter text content into this list item. Your unique, authentic, and appropriate text will be filled into this section.

  • Type the content for this list item here. This is just example text to show you what it will look like when you enter text content into this list item. Your unique, authentic, and appropriate text will be filled into this section.

Hang tight while we prepare your form...