Schedule an appointment
with Dr. Anthony O. Roberts
9715 Medical Center Drive, Ste 502
Rockville, MD 20850
(301) 279-0600

We speak English, & Español (Spanish).

Forms

Please download, print and complete the appropriate forms prior to your appointment.

Please remember to bring all completed forms to your appointment.

If you have any questions regarding any of the forms please contact our office and our staff will be very happy to answer any questions you may have. You can reach our office at (301) 279-0600.

Patient Forms – (Click the appropriate form to download)

• New Patient Form Packet 
• New Patient Form Packet (Spanish version – Version en español)
• Cataract Surgery Patient Form Packet
• LASIK Surgery Patient Form Packet
• PRK Surgery Patient Form Packet
• Prokera Patient Form Packet
• Refractive Lens Exchange Patient Form Packet

OTHER FORMS

• Patient Portal Consent Form
• Medical Records Release Request – ($20 Charge)
• MVA Vision Screening Form – ($15 Charge) – (This form can be submitted online during your office visit)