Patient Forms and Brochures

Please take a moment prior to your scheduled new patient appointment to download and complete our patient forms. We ask that you complete the forms and email them to BeckerMD@eyelidocs.com prior to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to meeting you. 

New Patient Registration Form (English)

New Patient Registration Form (Spanish)

Additional Treatment Brochures for Download:

Blepharitis Treatment

Blepharoplasty and Brow Repair

Blepharospasm

Botox-Fillers

Congenital Tearing

Ectropion (eyelid turning out)

Entropion (eyelid turning in) 

Enucleation

Ptosis Repair

Skin Cancer

Tear Duct Blockage

Thyroid Related Eye Disease

Spanish Blepharoplasty

Spanish Enucleation

Spanish Ptosis

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.