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Patient Record Optometry for iOS

By Garrett Wada Free

Developer's Description

With over 25 years experience in private sector, I know how patients don't like filling out patient information forms. These forms are to be filled out each year and is mandatory by the insurance companies. We as practitioners are responsible for those completed forms and it helps us understand the patients issues relating to their examination.

I have designed a virtual assistant that will assist patients in filling out these forms using voice recognition, and touch input. It's new, and it's really detailed. The program is set up for customization of Doctors name and addresses and also the doctor can select and remove certain questions that are asked of the patient. The program also allows the doctor to enter a customized price for additional testing such as OCT and Optomap scanning. Our program can be utilized in English and Spanish and we also have a hearing impaired instructional video that can be show to the patient prior to entering data into the iPad.

This application can be run on an Apple IPad or IPad Mini and can also hook up wirelessly to a Bluetooth headset for more privacy if necessary. This application will also allow you to take the patients photo to be part of the medical record. This is very useful in remembering patient faces and also useful for those duplicate name patients.

There is a simulated SIRI voice that guides the patient thru the program.

Details in program

Returning patient? Or new patient?




Date of birth with automatic age calculation

Social Security last 4 digits

Phone Number



How did they hear of the office?

Asks if the patient wears glasses or contact lenses and asks the appropriate history.

Reason for Visit

What options they are interested in purchasing with their new glasses

Contact lens fitting policy

Asks if interested in refractive surgery

Last eye exam and doctors name

Complaints with Vision

Previous Ocular Diagnosis

Previous Surgeries

Previous Medical Exam and doctors name

Social History Tobacco use? Recreation drug use?

Medical Conditions such as HTN and DM

HIPPA Compliance agreement accepted

Dilation Consent form allowed or refused

Offer of OCT iWellness Exam and states price

Offer OPTOS Photography and states a price

Asks the patient to take photos of their medical card

Statement of Financial Policy said

Insurance Authorization

And finally, the patient is requested to sign when a pop-up signature pad pops up and

patient signs with the finger.

Now, the best part of this is when completed, it will automatically save on the iPad and can be printed. it is saved as a PDF format in the Myapp folder and can be saved directly into your EMR. The printout will highlight things in red. No more looking at the patient information form with every condition listed. Only the selected items will be on the printout. It will also allow the Doctor to see all of vital information quickly. It will advise the doctor whether the patient would like to be dilated or wish additional testing such as the OCT and OPTOS testing on that days visit. It also prints their agreement to HIPPA Guidelines, and Contact lens fitting policy, as well as agreement Statement of Financial Policy, and insurance authorization.

The price of this application is $499.00 Lifetime use.

Free three days free trial period to try out to see if this will work for your office.

Please click on this link for instructions on how to use the app:


Full Specifications

What's new in version 2.5.1


Release June 3, 2020
Date Added June 3, 2020
Version 2.5.1

Operating Systems

Operating Systems iOS
Additional Requirements Requires iOS 10.0 or later. Compatible with iPad.


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