Vitreo-Retinal Consultants

(317) 582-1118 - (800) 899-3937


David V. Poer, M.D., F.A.C.S.

For Patients

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Patient Forms

We'd like to make your visit as pleasant as possible. For your convenience and to save you time the day of your appointment, simply print the following forms (they're the same forms you would receive in our waiting room) and complete them at your convenience. Then bring them with you the day of your appointment along with a few other important things. We look forward to seeing you.

Patient Personal Information:

 

Patient Medical History:

 

Electronic Prescription Information: