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  • Home
  • About Us
  • Our Doctors
    • Joseph W. Townley, M.D.
    • Thomas W. Hejkal, M.D.
    • Shane Havens, M.D.
    • Michael daSilva, M.D.
    • Kevin Langel, O.D.
    • Jordan J. Arens, O.D.
    • Matt Schekirke, O.D.
    • Lauren Dole, O.D.
  • Services
    • Cataract Surgery
    • Laser Assisted Cataract Surgery
    • Premium IOLs
    • Lasik Surgery
    • Glaucoma Care
    • iStent
    • Diabetic Eye Care
    • Comprehensive Eye Exams
    • Eyelid Rejuvenation
    • Dry Eye and MGD
    • Eye care information and Covid – 19
  • Patient Education
  • Patient Forms
  • Eyeoptics
  • Contact / Directions
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Patient Forms

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402-391-1100
8141 W Center Rd Suite #100 Omaha, NE 68124

Please open and print the forms using the links below before your appointment to save time.

Forms
Patient Registration Form

Financial/Privacy Policy Form

Pre Surgical Cataract Patient Questionnaire

Records Release Form

  • Home
  • About Us
  • Our Doctors
    • Joseph W. Townley, M.D.
    • Thomas W. Hejkal, M.D.
    • Shane Havens, M.D.
    • Michael daSilva, M.D.
    • Kevin Langel, O.D.
    • Jordan J. Arens, O.D.
    • Matt Schekirke, O.D.
    • Lauren Dole, O.D.
  • Services
    • Cataract Surgery
    • Laser Assisted Cataract Surgery
    • Premium IOLs
    • Lasik Surgery
    • Glaucoma Care
    • iStent
    • Diabetic Eye Care
    • Comprehensive Eye Exams
    • Eyelid Rejuvenation
    • Dry Eye and MGD
    • Eye care information and Covid – 19
  • Patient Education
  • Patient Forms
  • Eyeoptics
  • Contact / Directions
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8141 W Center Rd Suite #100 Omaha, NE 68124
402-391-1100