Patient Forms

New patients: Please print out the appropriate form from the list below and bring the completed form with you to your first appointment.

If you have any questions about these forms, please call either our West Chester (610-696-1368) or Exton (610-363-8960) office and we will be happy to assist you.

New Patient Questionnaire for Comprehensive Eye Examinations with Drs. Reto, Halscheid, Bakker & Budinger
Record Release from Clompus, Reto & Halscheid Vision Associates
Record Release to Clompus, Reto & Halscheid Vision Associates
Parent’s Questionnaire for Services with Dr. Scheiman
Patient Symptom Questionnaire for Services with Dr. Scheiman
Patient Satisfaction Survey
School Vision Questionnaire Dry Eye Questionnaire