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West Palm Beach Location

771 Village Blvd.

West Palm Beach, FL

561-683-2621

Pompano Beach Location

1800-B North Federal Highway

Pompano Beach, FL

954-783-9322

Coral Spring

635 N. University Dr.

Coral Springs, FL

954-905-3474

Hollywood Location

5727 Hollywood Blvd.

Hollywood, FL

954-962-7337

Online Forms

At Dr. Richard A. Berman and Associates, 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. Click here to download.
  • 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 your have regarding your eye health or vision on the form.


Download & Print Form



Download the Free AdobeReader®

Contact Us

We look forward to hearing from you.