Online Forms

At Southern Focus Vision 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.

Download the Free AdobeReader®

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

HIPAA Form

This a consent form for the use and disclosure of patient information for treatment, payment, or healthcare operations

Download & Print Form

Make a Payment

Did you get a billing notice in the mail or need to pay for contact lens or eye glasses? Click make a payment button below to pay your bill securely online or call our office at (205)-631-7700.

No Show Appointments & Late Cancellations

Appointments cancelled less than 24 hours in advance and no-show appointments will be subject to a $50 fee; this fee will not be covered by your insurance company.