Patient Center

Welcome to our Online Patient Center! Here you can get information about what to expect during your visit with our doctors as well as important forms you can complete before your appointment to save time.

We want your visit to be as stress-free as possible. Our staff will do everything we can to make sure your experience is pleasant and convenient. If you have any questions about these forms, please don’t hesitate to contact us.

What to Expect

When you visit our office, you will be warmly welcomed and we can answer any questions you may have about completing the paperwork so that Dayton Optometric Center may see you. Our team will work together to evaluate your eyes and provide relevant eye care treatment information, review your vision benefits and payment options, fit you for glasses or contact lenses, and focus on exceeding all of your expectations. If at any time you have questions about the process or your specific health information, please ask.

Get your child ready for their first eye exam!

Learn More

Patient Paperwork

Thank you for choosing Dayton Optometric Center for your eye and vision care. Please follow the New Patient History link below for the form required for all new patients. Print and complete these forms and bring them with you the day of your appointment.

Please also bring the following:

  1. Photo ID
  2. All Insurance Cards
  3. Completed paperwork (as stated above)
  4. List of any/all medications and eye drop (please do not bring your medication bottle(s) with you)
  5. Name and phone number of your family doctor
  6. Current glasses and/or contact lenses (if applicable)

Please note we require 24 hours notice for cancellations or rescheduling.
We will not be able to reschedule patients who do not show for their scheduled appointment or do not give 24 hours cancellation notice on two occasions.

New Patient Paperwork

We highly recommend Dayton Optometric. We have been patients there for many years and the entire staff is wonderful!
Susan S.

Payment Options

Dayton Optometric Center believes in providing the best value for you and your family. We have products and pricing that aims to accommodate all budgets and our office participates in most insurance programs. For patients who have little or no vision insurance coverage, flexible payment programs may be arranged. To learn more about our payment options, please call our office directly.

Our office accepts cash, check, and major debit and credit cards including MasterCard and Visa, as well as Care Credit.

Don’t forget to use your:

  • Flexible Spending Plans
  • Health Savings Accounts (HSA)
  • Medical Savings Accounts (MSA)
  • Cafeteria Plans for most of your eye care needs

Care Credit

The Care Credit card is available to help people pay for health care expenses, often with an introductory period that is interest-free. We accept Care Credit for all of our services. To learn more or apply for the card, visit Care Credit here.


We are providers for the following vision insurance plans. If you do not see your insurance plan below, please contact Dayton Optometric Center, as this list is not all inclusive. If you make an appointment by phone, please have your insurance information available. Remember, Vision and Medical insurance are not one in the same. Please contact your human resources department with any questions prior to giving us your insurance information.

The list below is not a complete list of insurance providers that accept. Please contact our office to check if we accept your insurance provider if it is not listed below. Also please be aware that VSP & EyeMed patients need to contact their provider to check to make sure your plan is accepted with us specifically.

All of the above plans can be used for all your eye care and eyewear needs, including eyeglasses, contact lenses, routine office visits and medical office visits.