Patient Forms

Home Patient Forms

Welcome to our Online Patient Center! Here you can get information about what to expect during your visit with Dr. Nguyen and Dr. Glauser as well as important forms you can complete before your appointment to save time.

We want your visit to be as stress-free as possible. Our staff will do everything we can to make sure your experience is pleasant and convenient. If you have any questions about these forms, please don’t hesitate to contact us.

Office Hours:

Monday – 8:00am – 5:00pm
Tuesday – 8:00am – 5:00pm
Wednesday – 8:00am – 5:00pm
Thursday – 8:00am – 5:00pm
Friday – 8:00am – 5:00pm
Saturday – Closed
Sunday – Closed

* We are closed every 1st Wednesday of the month from 12-1 for staff meetings

Patient Forms

New Patient Form >>

Complete Onlne

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COVID-19 Liability Waiver >>

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HIPAA Notice of Privacy >>

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Medical Record Release to Maui Optometry >>

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Medical Record Release from Maui Optometry >>

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Hart Chart Instructions >>

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Convergence Exercises >>

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What To Expect

When you visit our office, you will be warmly welcomed and we can answer any questions you may have about completing the paperwork so that Maui Optometry may see you. Our team will work together to evaluate your eyes and provide relevant eye care treatment information, review your vision benefits and payment options, fit you for glasses or contact lenses, and focus on exceeding all of your expectations. If at any time you have questions about the process or your specific health information, please ask.

Why is my personal background important?

In order to better tailor the eye examination to your needs, our doctor may review any current vision problems, your general health, as well as discuss your hobbies and lifestyle requirements.

Why does the doctor ask me, “Which is better: one or two?”

While evaluating your prescription, the doctor will ask you to compare a series of lenses to determine which allows you to see clearer. As the differences become less noticeable, the doctor will be closer to finalizing your prescription. If you’re having a hard time choosing between the options, it means you’re almost done with this part of the exam!

Why is it necessary to know my blood pressure?

In addition to other health concerns, high blood pressure can affect the blood vessels in your eyes, which could lead to future vision problems.

Is it necessary for the doctor to dilate my pupils during the exam?

Although pupil dilatation is not always necessary, the doctor may make this decision during your exam. If required, this painless process is like opening a door so the doctor can fully examine your retina. Dilation can assist in detecting diseases such as diabetes, high blood pressure, and macular degeneration.