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D E - L E N S
  • Located in Wuse, Gudu and Utako
  • Wuse: +234-808-358-8730
  • Gudu: +234-810-840-6080
  • Utako:+234-818-433-9441

Patient Resources

Patient Forms

More than ever, your vision and eye health influence the quality of life you live every day. At De-Lens Ophthalmics, Family Eye Care and Vision Centre, we understand how important your eyesight is to both you and our team of eye care professionals.

To help us provide you with efficient, personalized, and comprehensive eye care, we have made several patient forms available for download. Completing the appropriate form before your appointment helps reduce waiting time and allows our doctors and optometrists to better understand your visual and medical needs before your visit.

Kindly download, complete, and bring the appropriate form with you during your appointment or submit it electronically where applicable.

Available Patient Forms

Vision Therapy Referral Form

Used for referrals related to visual development, binocular vision issues, and vision therapy assessments.

Download Form

Medical History Questionnaire

Helps our clinicians understand your medical history, medications, allergies, and eye health concerns.

Download Form

Additional Forms


Note: Online screenings are for awareness only. They cannot diagnose eye diseases or replace a comprehensive eye exam with a qualified optometrist. If you notice blurry vision, eye pain, flashes, floaters, or sudden changes, book an in-clinic exam right away.

Why Complete Your Forms Before Your Visit?

Completing your forms ahead of time helps improve your overall experience at De-Lens Ophthalmics. It allows our team to prepare for your appointment, understand your concerns in advance, and provide faster, more personalized care during your visit.

  • Reduced waiting time during appointments
  • Better understanding of your eye and medical history
  • More accurate and personalized care
  • Improved efficiency during consultations

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