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For your convenience, you may download and print out the patient medical history form so that you may complete it at your leisure before you arrive for your appointment.
Consent form for Retinal Photography, Visual Field Screening, and Pupillary Dilation
Consent for fitting, evaluation, and follow up for contact lens wear
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These PDFs require a free plugin that may have come included with your browser.
If you are having difficulties opening these files
Click Here
to go to Adobe's web site for Adobe's PDF reader.
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777 West Southern Avenue Suite 515 Mesa, AZ 85210
Map It!
We are located on the south east corner of Southern and Extension.
Phone: 480-461-3937
Fax: 480-461-0331
Email Us
Tue, Thu 9:00am - 6:00pm
Wed, Fri 9:00am - 4:00pm
Monday by appointment. Closed Saturday and Sunday
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