Online Forms

At Burcham Eyecare Center, we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

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 your have regarding your eye health or vision on the form.

Download & Print Form


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Burcham Eyecare Center

Burcham Eyecare Center is Aurora’s premier vision care provider with the services of both an optometrist and an ophthalmologist. Our experienced doctors are affiliated with several prestigious organizations including:
  • American Academy of Ophthalmology
  • American Medical Association
  • American Osteopathic Association
  • American Osteopathic College of Ophthalmology
  • American Society of Cataract and Refractive Surgery
  • Colorado Medical Society
  • Colorado Society of Eye Physicians and Surgeons
  • International Society of Refractive Surgery
Request a consultation online or by calling (303) 340-4600

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