Patient Forms

Access our patient forms that you can fill out before your next visit to Dr. Davis Your Vision Source Provider in Las Vegas.

Our Forms

Electronic Forms:

Printable Forms :

Patient Information and Insurance Form [PDF]
Notice of Privacy Practices (HIPAA) [PDF]
Noticia de Practicas de Privacidad(HIPAA)[PDF]
Acknowlegement of HIPAA Receipt Form [PDF]
New Patient Vision History Interview Form [URL]
Existing Patient Vision History Interview Form [URL]

“After filling out my forms online, there was almost no waiting time. All of the staff was very friendly and professional. Testing was much more thorough than other places I have been to. There were several phases of the visit. Again, almost no waiting between phases. When one staff member was done, another took over. Dr Davis and his staff explained things in words that were easy to understand. The staff was very helpful in picking out a pair of glasses and gave me a complete break down of the cost with my insurance compared to what the cost would have been without insurance. I was very happy with the visit and would recommend Dr Davis and his staff to anyone.”

James F.