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


At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


Cynthia Norton

Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


Steve Fay

Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


Mary K.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


Allen B.
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Contact Us To Amplify Your EyeCare

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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, 10065
Fax
(212) 759-2220
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