Patient Form
Please click on the link below, print the forms and fill them out before coming for you first visit.
New Patient Registration Form - PDF
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.
To schedule an appointment, please call us at:
(919) 467-9955 - Cary, NC (919) 938-2010 - Smithfield, NC
Questions? Comments? Simply complete the form below.
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Ophthalmologist Dr. Dean Dornic, M.D., serving Raleigh and the surrounding areas. Eye Specialists of Carolina Cary Office: 3701 NW Cary Pkwy | Cary, NC 27513 | Tel: 919-467-9955 Smithfield Office: 1609 Booker Dairy Rd. | Smithfield, NC 27577 | Tel: 919-938-2010 www.eyespecialistsofcarolina.com