Online Forms

At Fishman & Sheridan Eyecare Specialists, we value your time. In an effort to save you time in our office, you can complete your new patient forms online by clicking on the link below corresponding to the type of appointment and location you're scheduled in: 

Routine and Medical Vision Care Appointments
Medicinal Marijuana Appointment
ClermontClermont (Medicinal Marijuana only)
EustisEustis (Medicinal Marijuana only)
LeesburgLeesburg (Medicinal Marijuana only)

*Make sure you select "SUBMIT" at the bottom of the  second page!

Alternatively, you may manually download and complete our patient form(s) prior to your appointment:

  • You will need AdobeReaderĀ® 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.

Patient Information Form

Download & Print Form

HIPAA Acknowledgment Form

Download & Print Form

Dilating Eye Drops Form

Download & Print Form

Refraction Acknowledgment  Form

Download & Print Form



Download the Free AdobeReaderĀ®

Contact Us

We look forward to hearing from you

Our Location

Hours of Operation

Monday

8:00 am - 5:00 pm

Tuesday

8:00 am - 5:00 pm

Wednesday

8:00 am - 5:00 pm

Thursday

8:00 am - 5:00 pm

Friday

8:00 am - 3:00 pm

Saturday

Closed

Sunday

Closed

Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
8:00 am - 3:00 pm
Saturday
Closed
Sunday
Closed