Patient Forms

Thank you for selecting Bloom Eye Associates for your vision care. To schedule an appointment at our Philadelphia ophthalmology office, call us at (215) 483-8444 or request an appointment online.

Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

• New Patient Registration Form
• Health History Form

Established patients can update forms online through our patient portal. If you need help accessing the portal, please call the office and we’ll be happy to help.

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.