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New Patient Center

Welcome to the New Patient Center for Epic Vision Eye Center

We understand that your time is precious and that you need an optometrist who is professional, yet convenient for your lifestyle. In order to make the transition to our office smoother for you, we have created a New Patient Center with everything you need to get started.

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. At Epic Vision Eye Center, we strive to make sure the time we spend with you during your visit is quality time.

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. 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.

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

Download the Free AdobeReader®

Main Office
PO Box 1095
Smithville, MO 64089

Main | 888.749.7755
Billing | 816.207.0055
Accounts Payable | 888.749.7755

[email protected]

  • Aisha Fields, O.D
  • Curtis Myers, O.D.
  • Douglas Stigge, O.D.
  • Jennie Kutschka, O.D.
  • Karli Hubka, O.D.
  • Matthew Callewaert, O.D.
  • Nick Mondero, O.D.
  • Qadium Qayum, O.D.
  • Ryan Hiesterman, O.D.
  • Tad Baker, O.D.
  • Tiffany Tiller, O.D.
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