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Patient Forms.

Patient Information File
File Size: 914 kb
File Type: pdf
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Please fill out the following patient information forms and bring them with you to your first visit. Signing "Acknowledgment of Receipt of Privacy Practices" on the form signifies that you have read the Privacy Policy, listed below.

  • Patient Information Form
  • Privacy Policy

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Our Optometry Clinic

​333 Main Street
Your City, CA  95512

​916-851-6556


Email Us
Hours:
Mon:  8am - 5pm
Tue:    8am - 5pm
Wed:  8am - 5pm
Thur:  8am - 5pm
Fri:      8am - 5pm
Sat:     8am - 5pm
Sun:    CLOSED

Premier Eyecare

540 Hughes Road - Suite 7
Madison, AL 35758
Hours
Monday: 9 am - 5 pm
Tuesday: 9 am - 5 pm
Wednesday: 9 am - 5 pm
Thursday: 9 am - 5 pm
Friday: 9 am - 1 pm

Closed for lunch: 1 pm - 2 pm
Contact Us
256-772-4005

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