Return Patient Update

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Reason For Appointment (check all that apply)*
Preferred Doctor*
Have you had any flu-like symptoms (fever, chills, etc) within tha past 14 days?*
Are you currently COVID +'ve or awaiting COVID test results?*
Digital Device Usage (computer, tablet, phone)*
Are You Using Private Insurance To Help Pay for The Exam or Eyewear?*
***if yes, please bring insurance card to appointment and verify eligibilty dates before coming for exam***
If you wish to process your exam or eyewear fees through private health care insurance, please ensure all this information is accurate (names are written as on card) and up to date.
This field is for validation purposes and should be left unchanged.