Lancaster | 603-788-3561
St. Johnsbury | 802-748-3536
Montpelier | 802-223-7723
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Online Forms

At Shippee Family Eye Care, P.C., 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.

Medical History Questionnaire

Please complete this form prior to your visit so we can accurately assess your existing conditions and future treatment. 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.


Patient Information

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.


Designation of Personal Representative

Please provide us with emergency contact information upon your visit.


Online Patient Portal

Please complete this form if you wish to be enrolled on our online patient portal.


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Office Hours

Lancaster | 150 Main St Lancaster, NH 03584

Monday - Thursday:

8:00 am - 4:30 pm

Friday:

8:00 am - 1:00 pm

Saturday, Sunday:

Closed

St. Johnsbury | 468 Hospital Dr. St. Johnsbury, VT

Monday - Friday:

8:00 am - 5:00 pm

Saturday, Sunday:

Closed

Montpelier | 114 Main St Montpelier, VT 05602

Monday - Friday:

8:00 am - 5:00 pm

Saturday, Sunday:

Closed

Locations