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Home Patient Forms

Please click on the location you are visiting to download forms:

Havasu Eye Center Forms

Parker Vision Center Forms

Blythe Vision Care Forms

Havasu Eye Center

383 Lake Havasu Ave,
Lake Havasu City, AZ 86403
Phone: (928) 680-1144
Fax: (928) 680-8639
Mon – Fri 8am to 5pm

Parker Vision Care

115 W. Riverside Dr.
Parker, AZ 85344
Phone: (928) 669-2497
Fax: (928) 669-8424
Mon – Fri 8am to 5pm

Blythe Vision Care

110 N. Spring St.
Blythe, CA 92225
Phone: (760) 922-3951
Fax: (760) 922-5202
Mon and Wed 8am to 5pm
Tues 8am to 4pm
Thurs 8am to 4pm or 8am to 5pm

Scheduling for URGENT eye care needs.

Per guidance from the Center for Disease Control and Prevention (“CDC”), the American Academy of Ophthalmology, and Arizona’s Governor Doug Ducey, Havasu Eye Center, Parker Vision Care and Blythe Vision Care are only scheduling appointments with patients that have urgent eye care needs.

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Patient Forms

Please click on the location you are visiting to download forms:

Havasu Eye Center Forms

Insurance Release (.pdf)

Patient Info Sheet (.pdf)

Parker Vision Center Forms

Insurance Release (.pdf)

Patient Info Sheet (.pdf)

Blythe Vision Care Forms

Insurance Release (.pdf)

Patient Info Sheet (.pdf)

Havasu Eye Center

Parker Vision Care

Blythe Vision Care