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Online Forms

At Michiana Eye Center, 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. Click here to download.
  • 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.

Location

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Office Hours

Our regular schedule
Monday:
08:00 am - 05:00 pm
Tuesday:
08:00 am - 05:00 pm
Wednesday:
08:00 am - 05:00 pm
Thursday:
08:00 am - 05:00 pm
Friday:
08:00 am - 05:00 pm
Saturday:
08:00 am - 12:00 pm
Sunday:
Closed

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Please do not submit any Protected Health Information (PHI).
Testimonials
Reviews By Our Satisfied Clients
"Dr. Anderson and his staff are so patient and friendly. Dr. Anderson prescribed me glasses and I had the toughest time picking out frames. They didn’t rush, but instead made helpful suggestions and now I have an awesome pair of frames, not to mention the fact that I can see ten times better than before. You guys are the best!"
Shelly

"I can say without a doubt that my experience with Michiana Eye Center has been life changing."
Jane Underly - Patient Mishawaka, IN