Your Time Is Important

At Cheyenne Eye Clinic & Surgery Center, we value your time. In an effort to save you time in our office and make your experience as pleasant as possible, you can download and complete our patient forms prior to your appointment.

Time-Saving Steps for a Great Appointment

Step 1. These files require AdobeReader® to open. If you don’t have AdobeReader®, please click here to download.

Step 2. Download your forms below, print them out and complete the required information.

Step 3. Fax your printed and completed forms to our office or bring them with you to your appointment.

Forms And Instructions

Patient Information Sheet - Required

Help us understand your history and the current state of your health, as well as what questions, concerns, and goals your have about your eye health or vision.

Medication Allergies

If you have any known allergies to medications, let us know with this form.

Medical History Form

For the highest quality of personalized care, help us with a few more details about your medical history.

Pre and Post Operative Instructions

If you’ve chosen us for your plastic surgery procedure, please read these general instructions for the best experience possible. Don’t hesitate to call us—at any time, day or night—with any additional questions.

Patient Records Request

Release Records to Cheyenne Eye Clinic & Surgery Center

Release Records from Cheyenne Eye Clinic & Surgery Center


Due to an office-wide system outage, Cheyenne Eye Clinic & Surgery Center will be operating on paper charts, and you may expect some delays (*Emergent cases will be prioritized).  If you would like to reschedule your appointment for a later time, our staff will be happy to assist you.  We will contact patients for non-urgent appointment scheduling once the system is back up and running. Thank you for your understanding.