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Patient Forms

Eye Patient Forms

Medical Optometric Eye Care | Same-Day Appointments | Since 2000

Medical Optometric Eye Care

Same-Day Appointments

Since 2000

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Hours:

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Form for Your Eye Appointment

Please take a moment to download and fill out the convenient patient form provided here by Jeffries Eye Care. Be sure to complete it and bring it with you to your exam. We appreciate your doing this ahead of your visit to save time for you as well as our dedicated team.


Call today if you have any questions.

Check Out Our New E-Check-In Feature!

If you are new to us or haven't visited us this year yet, simply click the link or scan the QR code then choose the appropriate references under the "packets" tab to go ahead and check-in for your appointment.


If you decide to use this feature, please inform the front desk of your name on the day of your appointment and let them know that you have checked in online. If you choose not to use this feature, we kindly request that you arrive 15 minutes early so that we can gather any necessary information.


We look forward to seeing you soon!




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Emergency and Same-Day Visits

Call Today for an Appointment!

(770) 450-1986

(770) 450-1986
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“Dr. Jefferies and her staff are always so nice and very caring about my eye care. They are also very knowledgeable in their roles at the office. I have asked Dr. Jefferies many questions about my eyes over the years and she answers them to my satisfaction. I recommend Dr. Jefferies to anyone who needs eye care. She does a great job.”

- Ricky M.

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Jeffries Eye Care

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