At Hendrix Eye Care, 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. Click here to download.
- 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.
Patient Demographics
Health Information Disclosure
Our Locations
321-383-1332
1917 Knox McRae Dr
Titusville, FL 32780
321-783-2002
5505 North Atlantic Avenue Suite 105
Cocoa Beach, FL 32931
1917 Knox McRae Dr
Titusville, FL 32780
321-783-2002
5505 North Atlantic Avenue Suite 105
Cocoa Beach, FL 32931
Business Hours:
Monday: 8am - 5pm
Tuesday: 8am - 5pm
Wednesday: 8am - 5pm
Thursday: 8am - 5pm
Friday: 8am - 5pm
Saturday: Closed
Sunday: Closed
Tuesday: 8am - 5pm
Wednesday: 8am - 5pm
Thursday: 8am - 5pm
Friday: 8am - 5pm
Saturday: Closed
Sunday: Closed