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patient  forms

Patient Forms


Welcome Form
File Size: 554 kb
File Type: pdf
Download File

Dilation Consent Form
File Size: 180 kb
File Type: pdf
Download File

This is an Informed Consent for Pupillary Dilation. Please print and fill out form prior to appointment and bring it with you, along with both pages of the WELCOME FORM.  See "Privacy Policy" link on this website for the HIPAA form.
THANK YOU!
Patient Form3
File Size: 6 kb
File Type: pdf
Download File

Patient Form4
File Size: 6 kb
File Type: pdf
Download File

Contact Us
12794 Royalton Rd. (RT 82)
North Royalton, OH 44133
Phone: 440-230-4362

Store Hours:
Monday           12:00 pm  -  7:00 pm
Tuesday            9:00 am  -  5:30 pm
Wednesday     12:00 pm  -  7:00 pm
Thursday            ----CLOSED----
Friday                9:00 am  -  5:30 pm
Saturday*         9:00 am  -  1:00 pm
Sunday               ----CLOSED----

*We are closed the first and last Saturday of the month
Notice of Privacy Practices
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  • Our Practice
  • Our Services
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  • Eye Care Articles
  • Location & Store Hours