WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]
3685 Center Circle Fort Mill, SC 29715
888-262-2020
m

At Vision Therapy Center of Charlotte, 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.  Completed forms should be emailed to Dr.Haleo@vtcharlotte.com or faxed to 704-973-0664.

  • 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.

Childrens Checklist

Download Now

Adult Checklist

Download Now

Head Injury Checklist

Download Now

New Patient Forms

Download Now

HIPPA Release Form

Download Now


Download the Free AdobeReader®