Online Patient Forms


Once you have contacted our office to schedule an appointment for you or your child, please click on the link below and complete the online history form.

  1. Choose the "New Patient" button
  2. Complete the DEMOGRAPHICS tab
  3. Next, choose the correct tab - either CHILD or ADULT.
  4. Finally, be sure to go to the SUBMIT tab and click the SUBMIT button.

If you prefer a paper version of the Child or Adult History Form, please let us know and we will be happy to mail you the paperwork to fill out.

History Forms »


We request that records from the most recent routine eye exam be sent to our office prior to a Vision Therapy Evaluation. You can download, fill out this form and send it to the office where the routine eye exam was completed, then they will fax your information to our office. This may not be necessary in cases of a direct doctor referral.

Records Release Form »


At Denver Vision Therapy, we take your health information privacy very seriously. We will not share your health information without your consent. We have posted a copy of our privacy practices at the link below. The second page of the document is for you to sign at your first appointment with our office.

Privacy Policy Form »


Functional vision problems can affect learning, reading, sports, work performance, and behavior. To find out if a vision therapy evaluation is recommended, you can fill out our easy, no obligation symptom checklist by clicking one of the links below.

Child Vision Symptom Checklist »

Adult Vision Symptom Checklist »