Patients | Eye Doctor Arlington | Northern Virginia Doctors of Optometry

Patient Forms

At Northern Virginia Doctors of Optometry, we strive to make sure the time we spend with you during your visit is quality time. In an effort to make you more comfortable when you arrive at our office and to streamline the new patient process, you will be able to complete all the necessary items prior to your first visit.

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.

General Forms/Policies

- Financial and Insurance Information: Download & Print Form
  - Español Financial and Insurance Information: Download & Print Form
- New Patient Health History Intake Form: Download & Print Form
  - Español New Patient Health History Intake Form : Download & Print Form
- Click here to print, read and sign a copy of our office’s financial policy.
- Click here to read a copy of our office’s privacy policy.
- Late Arrival Policy

Myopia Form

If you are coming in for a Myopia Control Examination, please complete this form in ADDITION to the New patient Health History Form:

Myopia Control Questionnaire: Download & Print Form

Low Vision Form

If you are coming in for a Low Vision Examination, please complete this form INSTEAD of the New patient Health History Form:

Low Vision Questionnaire: Download & Print Form

Insurance & Billing Information

You can explore the medical and vision insurances we accept below. Please call us directly at one of our locations to verify your routine benefits coverage. Please note that insurance is not accepted for the following services:

Myopia Control
Concussion Therapy
Sports Vision
Vision Therapy
Select Advanced Dry Eye Therapy

If you have any questions about your medical and vision coverage, please call your insurance provider for more details.

Schedule Appointment

We accept the following

Insurance

Vision Insurance we accept:

*We do not accept Spectera Vision, United Healthcare Vision, Blue Vision, or Davis Vision.

Enroll in Vision Insurance here

Medical Insurance we accept:

*We do not accept Medicaid, Cigna Connect, Anthem HealthKeepers Plus, or Kaiser Permanente.

Browse, Pay & Order Online

Patient Links

Pay Bill Online

Dry Eye Clinic

Dry Eye Store

*Enter PIN# 9252

Order Supplements

Browse Eyewear

Access Neurotracker

Alexandria

Arlington - Clarendon

Arlington - Crystal City

Arlington - Rosslyn

Berryville

Falls Church

Reston

Policies Privacy Policy Terms & Conditions

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Most patients qualify on a 6 months supply or greater.

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First time purchasing contact lenses with us
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Scheduling a Routine Eye Exam?

If yes, please proceed to scheduling online! If you need an Office Visit, Follow-up Testing, a Specialty Clinic appointment, or are interested in trying contacts for the first time, please call the office to schedule. These appointments require additional scheduling considerations.

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Schedule Online

Call Our Office

Please call to schedule an appointment if you are visiting a new office or have specialty testing needs.

Select Your Location:

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Call Crystal City

Call Clarendon

Call Falls Church

Call Reston

Call Berryville

Call Rosslyn

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Patient Resources