Patient Forms

EDOW is proud to offer you the best technology in all aspects of our practice, including our electronic medical record (EMR) system. When you come in for your appointment, we ask that you fill out our patient forms at our simple-to-use kiosk. You can review the forms below, but there is no need to print them for your appointment.

Laser Vision Correction Patients

Please review the following forms before your initial evaluation, although there is no need to print and bring them to your appointment:

Medical Records Requests

To obtain a copy of your medical records*, please download the following release form for the correct location.

The form may be sent via e-mail to or fax to: 202.688.2857

*Please inquire about the fee for obtaining a copy of your medical records.

Motor Vehicle Eye Exam

EDOW charges a $25 fee for paper or electronic vision screening forms. If the patient requests this form to be filled out during a scheduled appointment with their doctor, the EDOW fee is waived.

Related Pages

schedule an Appointment
pay my bill
provider Portal
(301) 215-7100

Our locations

Plaza North
4600 North Park Ave.
Chevy Chase, MD 20815
Chevy Chase Metro Building at Wisconsin and Western Avenues
2 Wisconsin Circle, Suite 230
Chevy Chase, MD 20815
8230 Boone Blvd, Suite 125
Vienna, VA 22182
5420 Olney Laytonsville Road
Olney, MD 20832
1016 16th Street NW
Lower Level 100
Washington, DC 20036
1145 19th St NW
Suite 335
Washington, DC 20036

Online Scheduling Maintenance

Our online scheduling portal is undergoing maintenance. We apologize for the inconvenience. Please call our office at 301.215.7100 to schedule an appointment. We look forward to seeing you as a patient!