Wallingford Eye Care Center

Wallingford Eye Care CenterWallingford Eye Care CenterWallingford Eye Care Center

(203) 265-5152

  • Home
  • About
    • About Us
    • Services & Technology
    • Eyewear Gallery
    • Promotions
  • Contact Us
    • General & Appointments
    • Contact Lenses
  • New Patients
    • Patient Forms
    • Insurance
  • Learn More
    • FAQ
    • Common Eye Issues
  • More
    • Home
    • About
      • About Us
      • Services & Technology
      • Eyewear Gallery
      • Promotions
    • Contact Us
      • General & Appointments
      • Contact Lenses
    • New Patients
      • Patient Forms
      • Insurance
    • Learn More
      • FAQ
      • Common Eye Issues

(203) 265-5152

Wallingford Eye Care Center

Wallingford Eye Care CenterWallingford Eye Care CenterWallingford Eye Care Center
  • Home
  • About
    • About Us
    • Services & Technology
    • Eyewear Gallery
    • Promotions
  • Contact Us
    • General & Appointments
    • Contact Lenses
  • New Patients
    • Patient Forms
    • Insurance
  • Learn More
    • FAQ
    • Common Eye Issues

New Patient Intake Forms

New and returning patients must complete the new patient paperwork (as applicable) prior to their visit. Children under 18 must have a parent or guardian sign each form.
​ 
​Be sure to complete all forms and hit Submit. If you would prefer to fill out paper forms, please scroll to the bottom of this page.

All Patient Intake Form

Contact Lens & LASIK Patients

Contact Lens & LASIK Patients

Complete these forms for patient intake. 


If you are an existing patient and would like to update your insurance on file, please complete this form. 

Patient Forms

Contact Lens & LASIK Patients

Contact Lens & LASIK Patients

Contact Lens & LASIK Patients

If you wear contacts, are interested in contacts, or have had LASIK surgery, please complete this form annually. 

Topography

Printable Paperwork

If you prefer to fill out paper forms, you can download the PDF here and print them at home.

Don't forget to bring them with you when you come in!

AllForms2021 (pdf)

Download
  • Home
  • About Us
  • Services & Technology
  • Contact Lenses
  • Patient Forms
  • FAQ

Wallingford Eye Care Center

821 North Main Street Ext, Wallingford, Connecticut 06492, United States

(203) 265-5152

Copyright © 2021 Wallingford Eye Care Center - All Rights Reserved.

Powered by GoDaddy

This website uses cookies.

We use cookies to analyze website traffic and optimize your website experience. By accepting our use of cookies, your data will be aggregated with all other user data.

Accept