Before You Arrive

Click on the links below before your first appointment to submit your new patient paperwork through our online secure sending system!

These forms must be submitted at least 48 hours prior to your appointment to allow the doctor to review them. Thank you!

Please note, for your initial dry eye evaluation appointment, do not wear contact lenses, and bring a list of any products and drops you are currently using in and around your eyes. (You may also bring in the products and drops if you prefer.)

Patient History & Dry Eye Evaluation Form

Payment Options

The Dry Eye Spa of West Michigan specializes solely in providing evaluations, diagnosis and treatments for Dry Eye Disease patients. The Dry Eye Spa of West Michigan does not bill insurance for evaluations, treatments, follow-up visits, or products. Payment for all services is required at the time of the service. Accepted payment methods are cash, personal check, and credit cards. A patient’s Health Savings/Flex Account may allow for reimbursement of out-of-pocket payments for the eye health services provided by the Dry Eye Spa of West Michigan. Patients will receive all necessary documentation for the evaluation and treatment services provided and the fees charged for them. Various OTC eye care products are sold at the Dry Eye Spa of West Michigan and are competitively priced to retail or online sellers.

Schedule Your Evaluation Today

Schedule your evaluation by calling us directly or filling out the form below! You are also able to ask your existing eyecare provider or primary care provider for a referral. Once your Evaluation and treatments are completed, a clinical report of the results can be sent to the referring doctor if so desired by the patient.

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