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Midwest Eye Center

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  • 1: Home
  • 2: Employment Opportunities
  • 3: Directions

  • Current page is 4: Patient Forms

  • 5: Affordable Financing
  • 6: Contact Us
  • 7: Why Choose Us
  • 9: Advanced Laser Vision Correction
  • 10: Meet Our Doctors
  • 12: Our Facilities
  • 13: Procedures
  • 13.2: LASIK Technologies
  • 14: Research
PATIENT FORMS

QUICK LINKS

TO LEARN MORE ABOUT AN EYE CONDITION OR PROCEDURE, MAKE A SELECTION FROM THE DROP-DOWN MENUS BELOW.

  • Select An Eye Condition
    • Normal Vision
    • Near Sightedness
    • Far Sightedness
    • Presbyopia
    • Blended Vision/Monovision
    • Cataracts
    • Diabetic Retinopathy
    • Dry Eye
    • Flashes & Floaters
  • Select A Procedure
    • Lasik
    • IntraLasik
    • Conductive Keratoplasty
    • Custom Cornea
    • HD Custom LASIK
    • Refractive Keratoplasty
    • Retina
    • Glaucoma
    • Plastics
    • Botox
    • LENZIK

Patient Forms

The patient forms below require Adobe Acrobat Reader to view them. The software can be downloaded for free here.

  • Welcome Letter
  • Registration Form
    • Online Registration Form
  • Questionnaire Form
    • Online Medical History Form
  • Signature Form
  • No Show and Cancellation Form
  • Eye History Form
    • Online Medical Eye History
  • Cataract and Refractive Lens Exchange Questionnaire

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CONTACT US

We Can Change the Way You See Your World!

Fill out and submit this form to learn more about MidWest EyeCenter. Get a copy of our free LASIK DVD for more information.

OUR LOCATIONS

East
Eastgate Professional Building
Suite 305
4452 Eastgate Blvd
Cincinnati, OH 45245
513.752.5700

West
6779 Colerain Ave.
Cincinnati, OH 45239
513.741.1313

Tri-County
119 West Kemper Rd.
Cincinnati, OH 45246
513.671.6112

South
7510 US Route 42
Florence, KY 41042
859.525-6215