For your convenience, health and safety we have adopted a contact free and paperless check-in procedure. Our forms are completely electronic and can be completed from any smart mobile device or on your personal computer. The link below will bring you to our secure portal through IntakeQ.  We require you to complete your Lakefront Eye Care Intake and Medical History Form prior to your appointment.

  • Have your photo ID ready.  The form includes an area where you are prompted to upload your photo ID.  This is for identification purposes when you arrive for your exam.  We are required to verify the identity (with a photo ID) of all patients who are using a vision plan or medical insurance.
  • If you have medical insurance, have your medical insurance card(s) ready.  Even if you are only using your vision plan for your visit, your medical insurance is kept in our system in case the need for medical eye care arises now or in the future.  This includes eye allergies, pink eye, dry eye/irritation, eye injuries, diabetic eye care or retinal conditions that can be diagnosed by the doctor during your comprehensive exam.
  • Our intake forms include our Notice of Privacy Policies for HIPPA compliance and you are prompted to acknowledge receiving with your signature you submit electronically.
  • Fill out this questionnaire at your own convenience. Your answers are saved as you go, so you don’t need to finish it all in one sitting.  Submit the form only when you have answered all that you can.

How the form works:

Following the link will take you to Lakefront Eye Care’s secure portal through IntakeQ and will prompt you to type your name and email.  Once you click “Continue” you will be sent an email from IntakeQ with the subject “Action Required: We require you to complete your Lakefront Eye Care Intake and Medical History Form prior to your appointment”.  Your answers are saved as you go, so you don’t need to finish it all in one sitting.  You can log back into your form by clicking the link sent to your email as many times as needed.  Once you submit you won’t be able to change your answers.  If you need to change something after you have submitted the form, the only option is starting over with a new form.  Please call or text the office with any questions.