Pike Place Office

(206) 448-7739

University Village Office

(206) 522-9323

Online Forms

At Cannon EyeCare, 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.
  • 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.

New Patient Health History Form – Required

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 you have regarding your eye health or vision on the form.

Download & Print Form


Download the Free AdobeReader®

Pike Place Office

Address

1906 Pike Pl 8 b,
Seattle, WA 98101

University Village Office

Address

2602 NE University Village St,
Seattle, WA 98105

Pike Place Office Hours

Monday  

Closed

Tuesday  

10:00 am - 5:00 pm

Wednesday  

Closed

Thursday  

10:00 am - 5:00 pm

Friday  

10:00 am - 5:00 pm

Saturday  

10:00 am - 5:00 pm

Sunday  

Closed

University Village Office Hours

Monday  

10:00 am - 6:00 pm

Tuesday  

10:00 am - 6:00 pm

Wednesday  

10:00 am - 6:00 pm

Thursday  

10:00 am - 6:00 pm

Friday  

10:00 am - 6:00 pm

Saturday  

10:00 am - 6:00 pm

Sunday  

Closed