Having the most up to date information on your general health and well being is the key to us being able to provide care that is absolutely unique to your needs. Fitzroy North Eye Centre prides itself on the thoroughness it undertakes to ensure you receive the best care available. Our retention of Patient Information complies with existing obligations under The Privacy Act 1988.
NEW PATIENT QUESTIONNAIRES
New patients: please complete a questionnaire and we will contact you for an appointment. If you have had a concussion or brain injury, please also complete a BIVSS Brain Injury Visual Symptom Survey
- New Patient Questionnaire - Adult
- New Patient Questionnaire - Pre Kinder
- New Patient Questionnaire - Primary School
- New Patient Questionnaire - Secondary School
PATIENT FORMS
- Brain Injury Vision Symptom Survey (BIVSS)
- Teacher Performance Report
- Dry Eye Symptom Survery
- Visual Snow Syndrome Checklist
CONSENT FORMS AND WAIVERS