Patient forms

Make your appointment at our office more timely with these tips. Complete the forms, sign them, and either bring them with you or send them to us by fax at (303) 237-9638.

Myopia Management Pack

New Patient Form

Dry Eye Pack

Vision Therapy Pack

Referral Forms

Covid 19 Declaration

Off-Label Use of ATROPINE for Myopia Management
Proper use of Atropine for our Myopia Management Patients and Parents
Proper Wear and Care of Soft Your Multifocal Contact Lenses for Myopia Control Patients and Parents
New patient packet
Speed Questionnaire
OSDI Questionairre
Medications & Dry Eye
Computer & Phone Use
Doctors Instruction Sheet
Ocusoft Program Summary
Instruction Sheet for Hot Compress
Frequently Asked Questions
VT Policies Reminder
Vision Therapy Program Summary
Vision Therapy Orientation Checklist
Vision Therapy Financial Agreement
Vision and Learning checklist
Homework Assignment
Therapy Consent to photo video
Vision Therapy onboarding checklist
Vision Therapy Profile Sheet
VT Equipment policy
VT Training in office signature sheet
Vision Training In-Office Procedures
What is Vision Therapy?
Therapy Insurance Q&A
Referral Form Vision Therapy
Acknowledgement of the notice of privacy practices
Referral form Low Vision
Functional & Developmental Vision Fax Referral
Referral Form Vision Therapy
Canceletion Policy
New Patient Packet
Cataract Surgery
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Testimonials


As a long time patient and grateful recipient of Dr Kavner's care for my whole family I can wholeheartedly tell others his care is exemplary. His knowledge base is thrilling, and how ability to synthesize his wisdom into useful, accessible information is comforting, to say the least. I cannot say enough about this kind, gentle man and his legendary skills - he was one of the fathers of Occupational Optometry.

 


Alicia C.

Dr. Wernick was very knowledgeable. He is absolutely exceptional. He was friendly and kind. His bedside manner was excellent, Highly recommended.


Eddie C.

Dr. Wernick is a great doctor. He made me feel very comfortable and explained everything that he was doing. Very knowledgeable and efficient. Highly recommend it. The staff was also very friendly and helpful.


Paige L.

The staff was professional, nice and attentive. The doctor answered all the questions that I had. His approach to patients is gentle and his bedside manner is excellent!


Millie B.

Dr. Wernick was fantastic! I got in right away, he answered all my questions and I always felt like I was in good hands. His staff is friendly and made sure to answer all my insurance questions. Can't recommend them enough


Cristella N.

Dr. Wernick was very informative and attentive. He answered all my questions and concerns. He didn't only check for my prescription, he also checked the health of my eyes. Overall, a great doctor and highly recommended!


Daniella R.

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Contact Us To Amplify Your EyeCare

Amplify EyeCare Manhattan Logo

Working Hours

Tuesday - Thursday
9:30am–5pm

Friday
9:30am–3pm

Saturday
9:30am–2pm

Sunday
Closed

Location
235 East 67th Street, Suite 201, New York, New York, United States, 10065
Fax
(212) 759-2220
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privacy policy
Cancellation Policy
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