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Online Forms

At Legacy Eye Care, 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 AdobeReaderĀ® 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.

Medical Questionnaire
Download & Print Form

Patient Registration Form
Download & Print Form

HIPPA Form
Download & Print Form

Medical Release Form
Download and Print Form


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Contact Us

We look forward to hearing from you.

Locations

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Hours of Operation

Our Regular Schedule

Petersburg Location - Dr. Foster & Dr. Murtaza

Monday:

9:00 am-5:00 pm

Tuesday:

Closed

Wednesday:

Closed

Thursday:

9:00 am-3:00 pm

Friday:

8:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

Colonial Heights Office - Dr. Nwaohuocha (D. N)

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-7:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-3:00 pm

2nd and 4th Fridays

Saturday:

9:00 am-2:00 pm

1st and 3rd Saturdays

Sunday:

Closed

South Hill Location - Dr. Foster

Monday:

9:00 am-3:00 pm

Tuesday:

9:00 am-4:00 pm

Wednesday:

9:00 am-4:00 pm

Thursday:

9:00 am-1:00 pm

Friday:

9:00 am-2:00 pm

Saturday:

Closed

Sunday:

Closed

Chester Location - Dr. Murtaza

Monday:

9:00 am-5:00 pm

Tuesday:

Closed

Wednesday:

11:00 am-6:00 pm

Thursday:

9:00 am-3:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed