Online Forms
We value your time! In an effort to save you time in our office, you can download and complete our patient form prior to your appointment.
- You will need AdobeReader® to download and complete the form.
- Download the required form. Print out the form and complete the required information.
- Bring the completed form with you to your appointment and please arrive a few minutes earlier than your scheduled appointment time to allow our staff to process your information.
New Patient Form
Please complete this form as it lets us know the history and current state of your health. Let us know what questions, concerns, and goals you have regarding your eye health or vision on the form
Download & Complete Form – Patient Intake Document
Download & Complete Questionnaire – COVID Consent
Download the Free AdobeReader®
Notice of Privacy Practices
Download & Print Privacy Practices – Coming soon!
Call Us
Location
Southshore Optometric
202 Broadway
Amityville, NY 11701
Hours
Sunday: Closed
Monday: 10:00AM – 4:00PM
Tuesday: 1:00PM – 8:00PM
Wednesday: Closed
Thursday: 10:00AM – 7:00PM
Friday: 12:00PM – 6:00PM
Saturday: 9:00AM – 3:00PM