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Forms

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LipiView Dry Eye Questionnaire

Present this form if you are experiencing dry eyes or will be having a dry eye evaluation.
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Extended Adult Vision Form

Please fill out this form if you are seeking vision therapy services for an adult patient and bring it with you to your appointment.
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Extended Child Vision Form

Please fill out this form if you are seeking vision therapy services for a pediatric patient and bring it with you to your appointment.
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HIPAA Form

Here is a copy of our privacy practices.
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Preschool Vision Form

Present this form if your child is 3, 4, or 5 years of age and will be having an eye examination. Please fill out the form completely.
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Youth Vision Form

Present this form if your child is between the ages of 6 and 18 years of age and will be having an eye examination. Please fill out the form completely.
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Employment Application Form

If you are applying for a job with EyeCare Specialties please fill out this form completely.
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Appointments

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Lincoln

402-420-2020

Beatrice

402-223-4098

Fremont

402-727-9220